Patients with significant pelvic trauma rarely have isolated pelvic fractures. Genito-urinary injuries are particularly common with injuries to the pubic symphysis or pubic rami. In a male, a urethrogram should be performed prior to placement of a Foley catheter, particularly if blood is noted at the meatus or scrotal or perineal hematomas are identified (Fig. 37.2a, b). A cystogram should also be obtained once the Foley is placed, which can be done with plain radiographs or CT. It is important to be aware that subtle bladder ruptures may be missed if the volume of injected contrast is too small. CT cystography is far superior in the detection of subtle injuries and is preferred compared to conventional cystogram if the clinical circumstances allow. In order to prevent streak artifact the contrast dose should diluted about 1:10 in saline when performing a CT cystogram.