At the same time, a free text of manuscript is available in html and pdf format. Retrograde urethrography followed by a micturating urethrogram revealed a stricture in the poste rior aspect of the bulbous urethra. Sixty milliliters of iv iopamidol iopamiro 300, bracco was. Urethrography refers to the radiographic study of the urethra using iodinated contrast media and is generally carried out in males. We recommend the use of this technique of retrograde urethrography without instrumentation to determine urethral disease when manipulation of the urethra. Clinical judgment should guide decisions about contrast quantity and use of infusion or injection technique. Between january and april 2004, 20 men were referred to our institute for management of urethral strictures. The purpose of this study is to describe our technique for pericatheter retrograde urethrogram pcrug and to evaluate the utility of a pcrug to detect a clinically significant leak after urethral reconstruction. Traditionally these two examinations have been carried out as separate procedures. Many times it falls to the urologist, who may not be immediately available.
First, rug is performed to visualize the adequately distended anterior urethra, and vcug is then performed to properly evaluate the posterior urethra, 1, 2. Acrsar practice parameter for the performance of adult. This fluid is used to fill the urethra, and pictures or images are taken using an xray camera. The device allows rug to be performed using a balloonless catheter and with assessment of the various problems of the urethra. Retrograde pyelography radiology reference article. Apr 22, 2020 a retrograde urethrogram is a radiologic procedure performed to examine the integrity of the urethra, a part of the lower urinary tract. Retrograde pericatheter urethrography rpu has been reported to be useful in assessing urethral healing at the anastomotic site. Retrograde urethrography rug is the fluoroscopic examination of the urethra via retrograde contrast filling. Bedside emergency department procedure where urology not. Step by step instructions on how to perform a retrograde urethrogram in an adult patient. To describe our technique of retrograde pericatheter urethrography rpu and its clinical use after urethroplasty.
Ascending urethrogram underestimates the length of anterior urethral stricture due to end on view. The normal symmetrical cone shape of this part of the urethra described by mccallum 1979 was uneven. The most widely used technique currently involves a foley catheter conventional technique. Between january 2008 and december 20, 387 patients with urethral stricture underwent urethroplasty at our center. There are two radiological methods for examination of the male urethra. Achieve 90% score on the stanford radiography and fluoroscopy inservice exam. To compare the efficacy of sonourethrogram and ascending urethrogram in the evaluation of stricture urethra. The role of retrograde urethrography in the planning of.
The thinsection transverse images and high scanning speed of ct have led to the development of promising new techniques for urethral evaluation. This method prevents significant leakage of contrast material during the retrograde injection and provides good anatomical information. The present study describes a perfected device for retrograde urethrography rug. Feb 03, 2018 retrograde urethrogram retrograde urethrography best initial study for urethral and periurethral imaging in men and is indicated in the evaluation of urethral injuries, strictures and fistulas. Therefore, this study was carried out in order to verify whether this technique can be used routinely as a diagnostic tool for the evaluation of the appropriate time for catheter removal after urethroplasty and. Urethrography urethrography refers to the radiographic study of the urethra using iodinated contrast media. Retrograde urethrogram of a 53 yearold male demonstrating normal anatomy. Abdominal radiology procedure manual educational goals. Ultrasonographic evaluation of urethral stricture disease. Please arrive 15 min before your scheduled appointment time. Excellent resource for radiology residents, technologists, and radi.
This document is for informational purposes only and is not intended to take the place of the care and attention of your personal physician or other professional medical services. In patients of stricture urethra with suprapubic catheter and where the proximal bulbous urethra is not visualized on vcug, antegrade urethrogram using our technique was performed. With these techniques, the voiding, contrastfilled urethra is scanned with 16mdct in approximately 6 sec. Demonstrate basic knowledge of the equipment used during fluoroscopy. The fluoroscopy service is an integral component of the abdominal imaging.
Jeffrey traubici, ruth lim, in comprehensive pediatric nephrology, 2008. A comparative study of sonourethrography and retrograde. Talk with your doctor if you have questions about individual health concerns or specific treatment options. Retrograde urethrography has been the standard imaging technique for the evaluation of male anterior urethra, which involves use of radiation and contrast medium. Sonourethrography is a new technique for imaging the.
Retrograde urethrogram procedure preparation md imaging. Indications for retrograde urethrography and cystography. Conventional urethrography although the most commonly used technique for diagnosis and characterization of anterior urethral stricture has limitations in accurate characterization with associated. Combined simultaneous voiding cystourethrography and retrograde urethrography can provide valuable treatment planning information in male urethral stricture disease. Fixation of the catheter is achieved by inflating a balloon in the fossa navicularis, which prevents extravasation on introduction of contrast material. Typically the procedure is performed in men after they have been subjected to a blunt force trauma, but can also be done in women. A simple technique of retrograde urethrography in male infants. Improper retrograde urethrogram technique leads to. This information sheet relates to the procedure being carried out on a male.
Ct voiding urethrography was performed as an independent ct examination n or as part of serial ct examinations n 1. Ask the patient to lie in supine position slightly tilted and legs position as shown in the video. Pdf ascending urethrogram and sonourethrogram in evaluation. Therefore, this study was carried out in order to verify whether this technique can be used routinely as a diagnostic tool for the evaluation of the appropriate time for catheter removal after urethroplasty and whether it can predict the success of urethroplasty. Retrograde urethrography rgu and micturating cystourethrography mcu by. A total of 343 of these patients underwent rpu 3 weeks postoperatively. Though retrograde urethrography is an examination not frequently performed, there are indications for this study that have remained constant for many years. T1 the role of retrograde urethrography in the planning of prostate cancer radiotherapy.
A penile clamp for retrograde urethrography using external compression by a balloon cather. Implication for patient care our study results show that the clamp method increases patient comfort during urethrography, as it is a painless procedure and. If you have any questions about how to prepare for your study, please call md imaging at 5302431297. Introduction urethrography is most commonly performed via the retrograde injection of radiopaque contrast into the urethra to elucidate urethral pathol. Tie a tourniquet below corona so that you can hold the genital, retract genital parallel to femur.
Improper retrograde urethrogram technique leads to incorrect. Improper retrograde urethrogram technique leads to incorrect diagnosis article in the journal of urology 1822. On initial presentation to the emergency department there are clear indications for performing these procedures. Through the suprapubic tract ureteric catheter urehrogram passed cystoscopically into the proximal urethra and contrast instilled to visualize the proximal urethra.
The urethra is the tube that runs from the bladder through the prostate and penis. Purpose retrograde urethrography is used, in combination with a doctors observation and other tests, to establish a diagnosis for individuals, almost exclusively men, who. It enables anatomic detail in the evaluation of the urethra in boys. Rug was performed in 42 patients with a mean age of 63. Guidelines for the evaluation of urethral and bladder.
Espr uroradiology taskforce imaging recommendations in. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. Pdf a perfected device for performing retrograde urethrography. Retrograde urography definition of retrograde urography. Retrograde urethrography rgu contrast is retrogradely injected with the urethral orifice. The urinary bladder was opacified by renal excretion of iodine contrast medium administered iv n or through infusion into a suprapubic tube n 1. The anterior urethra extends from the external meatus to the inferior edge of the. Straight forward, readily available, costeffective examination 12.
Retrograde urethrography is considered the gold standard for evaluating stenosis or urethral disease. To compare examination adequacy and patient discomfort during retrograde urethrography rug performed by using the conventional balloon method versus those of rug and voiding cystourethrography vcug performed with the clamp method of using drip infusion for the administration of contrast material. Nov 27, 2019 ascending urethrogram procedure pdf aka. A retrograde urethrogram is a routine radiologic procedure most typically in males used to image the integrity of the urethra. Retrograde urethrography rug is considered to be the best initial study for urethral imaging in men. If a radiological diagnosis is felt to be essential but to be used judiciously, a high index of suspicion is necessary in any patient. Conventional urethrography although the most commonly used technique for diagnosis and characterization of anterior urethral stricture has limitations in.
Retrograde pyelography was the first method devised for imaging the urinary collecting system, and until the development of early ivu agents in the 1930s, it was the only way of imaging the collecting system. Retrograde urethrography rug is the most accurate means of diagnosing and classifying urethral trauma currently available but is prone to overdiagnose complete injuries. Oct 02, 2008 the present study describes a perfected device for retrograde urethrography rug. Definition retrograde urethrography involves the use of xray pictures to provide visualization of structural problems or injuries to the urethra. A perfected device for performing retrograde urethrography. Retrograde pericatheter urethrography rpu technique and. Sep 14, 2017 the purpose of this study is to describe our technique for pericatheter retrograde urethrogram pcrug and to evaluate the utility of a pcrug to detect a clinically significant leak after urethral reconstruction. Magnetic resonance urethrography in comparison to retrograde. There is very limited pediatric literature available on this topic, which makes its performance and interpretation challenging. Following urethrography, you ascenving right away resume to your everyday activities without any restrictions. Novel pericatheter retrograde urethrogram technique is a. A urethrogram is usually carried out to show the cause of poor urinary flow thought. Introduction retrograde urethrography and voiding cystourethrography modalities of choice for imaging the urethra. The urethra is the tube that carries urine from the bladder and out the body.
Sonourethrogram was more proceure and specific in diagnosing urethral stricture disease in our study as compared to ascending urethrogram. Jul 29, 2019 a nuclear medicine thyroid scan uses a radioactive medication radiopharmaceutical to take pictures or images of the thyroid gland. Retrograde urography definition of retrograde urography by. When the urethra is studied with instillation of contrast into the distalanterior urethra it has been referred to as. It requires highresolution linear transducers and a penile and transperineal. An indigenous economic technique of positive pressure. The jelly makes it easy to insert the catheter if no urethral injury is detected. Retrograde pericatheter urethrography rpu technique and its. A new device for retrograde urethrography in the male.
Apr 12, 2015 step by step instructions on how to perform a retrograde urethrogram in an adult patient. If there is a urethral stricture a block or closing, urine cannot flow out. It is not a good technique to visualize the prostatic urethra in cases of posterior urethral disruption as it is difficult to maintain the ureteric catheter in the posterior uretbrogram and the contrast rapidly enters the bladder without properly filling the posterior urethra figure 2. We describe a technique of positive pressure retrograde urethrography using foley catheter and rubber stopper, inexpensive and could be adopted in. In the setting of suspected trauma to the male urethra, retrograde urethrography is still the study of choice to. N2 this analysis was performed to examine the role of retrograde urethography in the planning of prostate cancer irradiation.
This is a diagnostic test for male patients with trauma injury to the urethra. Overview a retrograde urethrogram rug is a diagnostic procedure performed most commonly in male patients to diagnose urethral pathology such as trauma to the urethra or urethral stricture. A urethrogram is an examination of the urethra by xray imaging, almost always carried out on males. Retrograde urethrography rug and voiding cystourethrography vcug are the modalities of choice for imaging the male urethra. Retrograde urethrogram, retrograde cystourethrogram catheter placement. There is very limited pediatric literature available on this topic, which makes its.
Sep 24, 2018 a retrograde urethrogram rug is a diagnostic procedure performed most commonly in male patients to diagnose urethral pathology such as trauma to the urethra or urethral stricture. Urethrogram figures 1285 and 1286 is performed by placement of the tip of a foley catheter into the entrance of the urethra, followed by instillation of 50 ml of contrast under low pressure usually gentle hand injection or gravity. Joshua broder md, facep, in diagnostic imaging for the emergency physician, 2011. Antegrade cystoscopy is performed through the suprapubic tract using a 19f sheath and a 0 or 30 cystoscope lens. The procedure is simple and well tolerated by patients and represents an interesting alternative to the conventional rug technique. Technical skills by end of the 2nd rotation, the resident should be able to 1. The procedure involves the insertion of a foley catheter into the distal urethra and minimally. To compare the clinical relevance of retrograde urethrography rug and magnetic resonance mr urethrography in evaluating male urethral strictures.
Printable version procedure after test printable version home urologic conditions retrograde urethrogram. To describe the clamp method for optimizing retrograde urethrography rug using a perfected device and a drip infusion system. Usually double balloon catheter is required forpositive pressure retrograde urethrography in females. Terminology when the urethra is studied with instillation of contrast into the distalanterior urethra it has be. Unfortunately, too few people know how to perform this test, and not all radiologists are familiar. Abdominal radiology procedure manual educational goals 2014 v4. Antegrade urethrogram delineates the proximal urethral segment till the strictured area. The modifications to the device are shown, and the steps of the technique described. Rguprimary imaging modality for evaluating traumatic injuries, inflammatory and stricture diseases of male urethra. Position patient in rpo position supported with wedge cushion. In the procedure a dye is injected into the urethral opening, and the movement. Any information contained in this pdf file is automatically generated from digital. An alternative to fluoroscopic retrograde urethrography is the usguided retrograde filling and distension of the urethra a sonographic urethrogram with saline or us contrast agent using the same technique of retrograde filling and distension of the urethra. There is fast growing authorship and readership with jcdr as this can be judged by the number of articles published in it i e.
936 110 985 838 1495 863 1097 558 830 1152 821 20 862 1440 1546 663 1584 1419 724 1046 16 924 1367 487 716 689 1180 870 19 1493 1494