A retrograde urethrography is a routine radiologic procedure (most typically in males) used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture.
Indications and contraindications
There is no absolute contraindication for retrograde urethrogram. There are several relative contraindications such as: allergy to contrast agents, acute urinary tract infection, and recent instrumentation of urethra.
The procedure involves the insertion of a Foley catheter into the distal urethra and minimally inflating it. This is followed by instillation of 30mL of water-soluble contrast and a plain radiograph is obtained; leakage of the contrast suggests urethral injury (usually secondary to pelvic trauma) and is an indication for surgical intervention.
It is used when there is suspicion of urethral trauma, such as a history of trauma to the area followed by pain, inability to void urine, or the presence of blood at the urethral meatus, a scrotal hematoma, or free-floating prostate on rectal examination.
If a urethral injury is suspected, a retrograde urethrography should be performed before attempting to place a Foley catheter into the bladder. If there is a urethral disruption, a suprapubic catheter should be placed.
- Retrograde ureteral, an intervention used to remove kidney stones
- Shetty, Aditya. "Urethrography | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 2021-11-10.
- El-Ghar MA, Osman Y, Elbaz E, Refiae H, El-Diasty T (July 2009). "MR urethrogram versus combined retrograde urethrogram and sonourethrography in diagnosis of urethral stricture". Eur J Radiol. 74 (3): e193–e198. doi:10.1016/j.ejrad.2009.06.008. PMID 19608363.
- Maciejewski, Conrad; Rourke, Keith (2015-12-02). "Imaging of urethral stricture disease". Translational Andrology and Urology. 4 (1): 2–9. doi:10.3978/j.issn.2223-4683.2015.02.03. ISSN 2223-4691. PMC 4708283. PMID 26816803.
- Hota, Parta; Patel, Tejas; Patel, Harshad; et al. (February 2020). "Post-traumatic Retrograde Urethrography: A Review of Acute Findings and Chronic Complications". Applied Radiology. 49 (1): 24–31.
- New England Journal of Medicine procedure videos: Male Urethral catheterization
- Ohio State University Patient Education Materials: Retrograde Urethrogram