Retrograde Urethrography


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Retrograde Urethrography

 

Definition

Retrograde urethrography involves the use of x-ray pictures to provide visualization of structural problems or injuries to the urethra.

Purpose

Retrograde urethrography is used, in combination with a doctor's observation and other tests, to establish a diagnosis for individuals, almost exclusively men, who may have structural problems of the urethra.

Precautions

The doctor should be made aware of any previous history of reactions to shellfish, iodine, or any iodinecontaining foods or dyes. An earlier allergic reaction during a dye study is not necessarily something that makes the test inadvisable (a contraindication) as no dye is injected into the bloodstream for this study. Other conditions that should be considered by the physician before the test is done include pregnancy, recent urethral surgery, or severe inflammation of the urethra, bladder, or prostate.

Description

The urethra is first visually examined by the doctor, and the opening is cleansed with an antiseptic solution. A flexible rubber or plastic catheter is then inserted into the urethra, and dye is injected into the catheter. A clamp is applied to hold the dye in place while x-ray pictures are taken of the urethral structure. The clamp and catheter are then removed. The procedure takes approximately 15 minutes. However, the patient may be asked to wait while films are developed, which also permits the patient to be observed for any immediate side effects from the dye. The test may be performed in a hospital, doctor's office, outpatient center, or freestanding surgical facility. The time involved for reporting of test results to the doctor may vary from a few minutes to a few days.

Preparation

The patient will be asked to sign a consent form after the risks and benefits of the procedure have been explained. No diet or activity changes are necessary in preparation for the procedure. The patient will be asked to remove all clothing and put on a surgical gown before the test begins.

Normal results

The presence of no anatomical or functional abnormalities is considered a normal result.

Abnormal results

Abnormal findings may indicate:
  • congenital abormalities
  • fistulas or false passages
  • lacerations
  • strictures
  • valves, known as "posterior urethral valves"
  • tumors

Resources

Organizations

American Kidney Fund (AKF). Suite 1010, 6110 Executive Boulevard, Rockville, MD 20852. (800) 638-8299. http://216.248.130.102/Default.htm.
National Kidney Foundation. 30 East 33rd St., New York, NY 10016. (800) 622-9010. http://www.kidney.org.

Key terms

Bladder — The balloonlike organ in the lower abdomen that holds urine.
Catheter — Tube used to inject into or withdraw fluids from the bladder.
Renal — Relating to the kidneys, from the Latin word for kidneys, renes.
Urethra — Tube that carries the urine from the bladder out of the body.
Visualization — The process of making an internal organ visible. A radiopaque subtance is introduced into the body, then an x-ray picture of the desired organ is taken.
References in periodicals archive ?
(iv) KEY MESSAGE 4: "evaluate urethral injuries with flexible cystoscopy and/or retrograde urethrography" (EAU strong recommendation)
However, in the case of accessory or hyposplastic urethras or non-communication a retrograde urethrography may be required.
Results: Retrograde urethrography showed 100% sensitivity, 97.78% positive predictive value and 97.78% diagnostic accuracy.
The main diagnostic imaging procedures include voiding cystourethrography intravenous pyelography ultrasonography (USG) retrograde urethrography and MRI.
They detail how to perform and interpret all types of procedures for each part of the gastrointestinal and genitourinary tracts, including the modified barium swallow, videoflouroscopic pharyngography, double and single-contrast esophagography and upper GI exams, small bowel follow throughs, enteroclysis, double and single-contrast barium enemas, evacuation proctography, and all types of postoperative GI studies, as well as retrograde urethrography, voiding cystography, and retrograde pyeloureterography.
Dynamic retrograde urethrography was requested as a part of routine urological evaluation, which revealed complete duplication of the penile and bulbous urethra (Figures 1 and 2).
Retrograde urethrography and cystography are other diagnostic methods that are used to verify any communication between the sinus and urinary system.
Caption: Figure 4: Retrograde urethrography at 10 months.
Mostly it is diagnosed by retrograde urethrography. Recently sonourethrography has been used to diagnose urethral stricture after saline instillation in urethra.