Pelvic ring fracture with blood at the meatus and a high-riding prostate on PR is the classic picture of posterior (membranous) urethral rupture. Membranous urethral rupture is almost always linked to a pelvic fracture. Do not pass a urethral catheter; a suprapubic cystostomy is the first step, and an ascending urethrogram can be done if in doubt. Bladder injury causes haematuria but no high-riding prostate.