Espr uroradiology taskforce imaging recommendations in. Retrograde urethrography rgu contrast is retrogradely injected with the urethral orifice occluded to prevent reflux of contrast. A catheter is put in place into the urethra, and it is filled with a waterbased contrast material. Retrograde urethrography rgu is an important means to visualize the anterior urethra in men in cases of suspected urethral injuries and strictures.
Though retrograde urethrography is an examination not frequently performed, there are indications for this study that have remained constant for many years. Retrograde urethrography rug evaluates better the anterior, while voiding urethrography vug the posterior urethra. Magnetic resonance urethrography in comparison to retrograde urethrography in diagnosis of male urethral strictures. Not uncommonly, contrast is injected under pressure to overcome the resistance of a stricture which can lead to extravasation or intravasation exposing the patient to risk of bacteremia, sepsis, contrast reactions, and worsening of stricture. This information sheet relates to the procedure being carried out on a male. The male urethral imaging and pathology is not widespread in the radiology literature because this part of the urinary tract is easily studied by urologists with clinical or endoscopic examinations. This prospective study was approved by the institutional. Demonstrate basic knowledge of the equipment used during fluoroscopy. Ultrasonography and mr imaging are increasingly being used in association with voiding cystourethrography and retrograde urethrography. Positive contrast retrograde urethrography proved to be a useful and relatively simple technic for the evaluation of lower urinary tract disorders in the dog. Achieve 90% score on the stanford radiography and fluoroscopy inservice exam. The procedure involves the insertion of a foley catheter into the distal urethra and minimally. Rguprimary imaging modality for evaluating traumatic injuries, inflammatory and stricture diseases of male urethra. A urethrogram is an examination of the urethra by xray imaging, almost always carried out on males.
Normal retrograde urethrogram rug, followed by a normal voiding cystourethrogram vcug retrograde urethrogram. There is very limited pediatric literature available on this topic, which makes its performance and interpretation challenging. 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. Retrograde urethrography rug is the fluoroscopic examination of the urethra via retrograde contrast filling. A comparative study of sonourethrography and retrograde. Detail the appropriate technique for performing a retrograde urethrogram rug, along. Trauma and obstruction of the urethra are clinical indications for this procedure.
In the setting of suspected trauma to the male urethra, retrograde urethrography is still the study of choice to assess for a disrupted urethra. This method prevents significant leakage of contrast material during the retrograde injection and provides good anatomical information. Antegrade vcug bladder is filled with contrast via suprapubic or retrograde catheterization and the urethra is assessed during voiding. A urethrogram is usually carried out to show the cause of poor urinary flow thought. This is a diagnostic test for male patients with trauma injury to the urethra. The anterior urethra extends from the external meatus to the inferior edge of the. A retrograde urethrogram is an xray exam of the urethra, the tube that carries urine from the bladder to the outside of the body. Retrograde urethrogram is employed for adequate demonstration of anterior urethral stricture and is commonly performed by trainee residents. Definition retrograde urethrography involves the use of xray pictures to provide visualization of structural problems or injuries to the urethra. Full text full text is available as a scanned copy of the original print version. To describe the clamp method for optimizing retrograde urethrography rug using a perfected device and a drip infusion system. Retrograde urography definition of retrograde urography. Accurate imaging of urethral strictures is critical for preoperative staging and planning of reconstruction. Abdominal radiology procedure manual educational goals.
The penis is postioned at approximately the 10 oclock position. A cystogram is a special xray examination of the urinary bladder. 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. Sonourethrography is a new technique for imaging the male anterior urethra with highresolution ultrasound while intraurethral instillation of. It requires highresolution linear transducers and a penile and transperineal. Introduction urethrography is most commonly performed via the retrograde injection of radiopaque contrast into the urethra to elucidate urethral pathol. Get a printable copy pdf file of the complete article 173k, or click on a page image below to browse page by page. The posterior urethra is being studied with voiding. Cystography and urethrography preamble this document is an educational tool designed to assist practitioners in providing appropriate radiologic care for patients. If there is a urethral stricture a block or closing, urine cannot flow out. The normal symmetrical cone shape of this part of the urethra described by mccallum 1979 was uneven. In retrograde urethrography rug, contrast media is injected into the.
Any information contained in this pdf file is automatically generated from digital material submitted to. Step by step instructions on how to perform a retrograde urethrogram in an adult patient. It enables anatomic detail in the evaluation of the urethra in boys. Excellent resource for radiology residents, technologists, and radi. Urethrography refers to the radiographic study of the urethra using iodinated contrast media and is generally carried out in males. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. The purpose of the current, prospective, analytical study was to quantify the urethral size of five, healthy, intact, male beagle dogs using retrograde ct urethrography and a power injector.
Technical skills by end of the 2nd rotation, the resident should be able to 1. The current gold standard, retrograde urethrography rug, allows for accurate diagnosis, staging, and delineation of urethral strictures, and remains a cornerstone in the management of urethral stricture disease. The round opaque structure in the distal penis is the inflated foley balloon. Talk with your doctor if you have questions about individual health concerns or specific treatment options. Due to the discomfort perceived by most patients during rgu and cystoscopy, some investigators advocated the routine use of local. Acrsar practice parameter for the performance of adult. This diagnostic test is commonly performed in male patients when narrowing of the urethra is suspected. Retrograde urethrography rgu is a common investigation.
Illustrate the normal and postsurgical anatomy of the male urethral system. One thing im finding out is that in urology, there are a lot of terms that just need looking up, because they are not common to lay people like me, who is just trying to make it through the many months i have to wear a suprapubic catheter and prepare for an attempt to fix my urethral stricture. Pdf juan d bernamestre jr1, jd bernaserna21department of radiology, university hospital of salamanca, spain. The urethra is the tube that runs from the bladder through the prostate and penis. Introduction retrograde urethrography and voiding cystourethrography modalities of choice for imaging the urethra. You will lie on your back or side, and an xray of the urethra and bladder are taken. Any information contained in this pdf file is automatically generated from digital material submitted to epos by third parties in the form of scientific presentations. Clinicians planning nonurgent intervention for a known stricture should determine the length and location of the urethral.
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 comparative study of sonourethrography and retrograde urethrography in evaluation of anterior male urethral strictures. Imaging of the normal male urethra from the neonate to the. When the urethra is studied with instillation of contrast into the distalanterior urethra it has been referred to as. The radiologist will talk with you about your exam and xray images. Use of retrograde urethrography in the resuscitation room. A retrograde urethrogram is an xray examination of the urethra. Retrograde urethrography has been the standard imaging technique for the evaluation of male anterior urethra, which involves use of radiation and contrast medium. Imaging of urethral pathology before and after treatment. Snomedct retrograde urethrogram procedure 302799008, snomedct voiding urethrocystography procedure. A retrograde urethrogram is a routine radiologic procedure most typically in males used to image the integrity of the urethra. The urethra is the tube that carries urine from the bladder and out the body.
References to any names, marks, products, or services of third parties or hypertext links to third. Retrograde urethrography rug combined with micturating cystourethrography mcug is imaging method of choice for studying the urethra and its abnormalities19. Purpose retrograde urethrography is used, in combination with a doctors observation and other tests, to establish a diagnosis for individuals, almost exclusively men, who. Small amounts of xrays are passed through the body.
Pdf magnetic resonance urethrography in comparison to. You m ay also read your results on your ecare results page. Retrograde pericatheter urethrography rpu has been reported to be useful in assessing urethral healing at the anastomotic site. Synchronous retrograde and micturating cysto urethrography. Retrograde pericatheter urethrography rpu technique and. Recently, a method of retrograde ct urethrography using a power injector was described. Retrograde ct urethrography using a power injector. Retrograde urethrography is considered the gold standard for evaluating stenosis or urethral disease. To compare the clinical relevance of retrograde urethrography rug and magnetic resonance mr urethrography in evaluating male urethral strictures. How do i view different file formats pdf, doc, ppt, mpeg on this site.
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. Clinicians should use urethrocystoscopy, retrograde urethrography, voiding cystourethrography, or ultrasound urethrography to make a diagnosis of urethral stricture. Xray contrast agent dye is gently moved into your urethra. 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. Practice parameters and technical standards are not inflexible rules or requirements of practice and are. Synchronous retrograde and micturating cysto urethrography a modification okpala oc, okafor c, abstract background.
Retrograde urethrography is the primary imaging modality for evaluating traumatic injuries and inflammatory and stricture dis eases of the male urethra. Pdf a perfected device for performing retrograde urethrography. A simple technique of retrograde urethrography in male infants. Mr urethrogram versus combined retrograde urethrogram and sonourethrography in diagnosis of urethral stricture. Between january and april 2004, 20 men were referred to our institute for management of urethral strictures.
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