This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Following urethral rupture, immediate procedure to be done is: September 2008, March 2009 
Select and explain. 
A. Urinary catheterization, B. Suprapubic cystostomy, C. Referral to a urologist, D. Observation
B: Suprapubic cystostomy
Answer: B: Suprapubic cystostomy 
Explanation: Ans. B: Suprapubic cystostomy Patient should be discouraged from passing urine if urethral rupture is suspected. Drainage of full bladders with paial tears can be managed with a suprapubic catheter. Suprapubic cystostomy has the benefit of avoiding urethral manipulation, which can produce fuher urethral trauma and allows for a simultaneous study to be carried out later. If the bladder is not easily palpable suprapubically, inse the catheter using transabdominal sonography If the patient has passed urine when first seen and there is no extravasation, the rupture, if any, is paial and a catheter is not needed.