<prompt> If a patient with a suspected fracture of the pelvis has some bleeding from the urethra and is unable to pass urine. What should be the next appropriate step in the management?He should be encouraged to pass urine after being given antibiotics and analgesicsHe should be immediately catheterized in the wardA hot water bottle should be given followed by injection of carbacholHe should be prepared for surgery and catheterization attempted in the O.T.  <response>: Urogenital injuries are common in pelvic fractures 5-10, especially in men. These injuries should be suspected in conscious patients Who is unable to void or who has gross hematuria Bloody urethral discharge Swelling or ecchymosis of the penis or perineum High riding or floating prostate on rectal examination Management No attempt should be made to pass a catheter, as this could conve a paial to a complete tear of urethra. A retrogram should be obtained before attempting to introduce a foleys catheter. Retrograde urethrogram positive: When a paial or complete urethral disruption is diagnosed on retrograde urethrogram then suprapubic cystotomy should be performed. Retrograde urethrogram negative: Catheterization can be safely undeaken Ref: Current Diagnosis Treatment in Ohopedics 3e, page 151; Apleys 8e, page 672-73; Rockwood Greens fracture in Adults 6e, Page 1618-1; Watson Jones: Fracture Joint Injuries 6e, Page 867. 