determining need for surgical repair, but these modalities are not especially useful in the initial evaluation It is recommended that, whenever possible, a full speculum examination be performed in females with gross hematuria and pelvic ring fractures, difficulty placing a urethral catheter, and anticipated delay until the pelvic fractures are stabilized as injury often extends to the vagina Management In the acute setting, partial anterior urethral injuries in males can be managed by to 10 days of urethral catheterization More severe injuries may require urinary diversion by suprapubic cystostomy Initial management of anterior urethral injuries remains controversial Urologic follow-up is required as the most common sequelae of anterior urethral injury, urethral stricture, may take months or longer to manifest and is usually managed definitively in a delayed fashion Penetrating wounds of the urethra demand early surgical exploration with conservative debridement and primary repair Patients with extensive loss of urethral tissue can be managed with delayed repair and staged reconstruction The acute management of posterior urethral injuries also remains controversial The comparative effectiveness and benefits of immediate exploration and realigning the urethra over an indwelling urethral catheter versus placement of a suprapubic tube and delayed urethroplasty are debated by experts Primary repair of posterior urethral injuries is generally discouraged For urethral injuries in females, most authors recommend some form of primary operative repair of the urethral rupture with closure of associated vaginal tears Placement of a suprapubic tube and delayed repair are reserved for unstable patients, as placement has been associated with scarring, strictures, urethral obliteration, and fistulas Long-term complications of this injury include urethrovaginal fistula, vaginal stenosis, incontinence, sexual dysfunction, and urethral stricture Clinical Indications for Discharge or Admission For children with isolated straddle injuries that not result in urethral rupture, it is necessary to ensure that the child can void and empty their bladder prior to discharge Occasionally, a catheter may need to be placed for to days to allow bladder drainage while the urethral edema resolves Follow-up with a urologist is essential as urethral stricture formation is a common long-term consequence of these injuries More severe urethral injuries, including those that result in urethral rupture, require admission All patients with posterior urethral injuries are to be admitted given the severity of the associated pelvic injuries