013 191 urethrography

Correspondence Address:

Prof. M. Shuja Tahir,

Professor of Surgery

Independent Medical College & Hospital Faisalabad.

Key Contents

Definition of Urethrography.

Indication of Urethrography.

Procedure of Urethrography.

Complications of Urethrography.

Learning Objectives

To able to explain Urethrography.

To enumerate reasons to perform.

To interpret the Urethrography.

To know the problems of Urethrogram.

Article Citation: Tahir S, Urethrography, Indep Rev Apr-June 2012;14(4-6): 271-274

Independent Review Vol:14: No:2 (271-274) 271www.indepreviews.com

Urethrography

Indep Rev Apr-June 2012;14(4-6) IR-191

M. Shuja Tahir

Key words: Urethrogram, Strictures urethra, Periunethral abscess.


Urethrography 2

It is the contrast medium radiological study of patient in a way only to keep the external

the male urethra. It shows the anatomy of genitalia exposed.

urethra and any pathology if present. Females ! 20 mls syringe

have small urethra and urethrography is ! Blunt tipped catheter (6fr-10fr size)

neither helpful nor performed. It is usually ! Hypaque or urographin solution

termed as retrograde urethrography. ! Penile clamp

It is considered to be the best initial

investigation for urethral and peri-urethral

imaging in men.

Only interior of urethra can be seen with this

method of examination (x-ray urethrography).

Urethral wall and periurethral tissue can not

be examined. Very tight strictures which do

not allow the passage of dye cannot be

assessed adequately with this method of

examination. Still it is better investigation for

posterior urethral strictures.

! Stricture urethra

! Pelvic fracture and suspected urethral

injury

! Rupture urethra The examination is conducted in the radiology

! Stone urethra department.

! Foreign body urethra

! Neoplastic lesions of urethra The syringe is filled with 20 mls of hypaque or

! Urethro rectal fistula urographin solution. The catheter is attached

! Urethro vaginal fistula to syringe and air is removed from the

! Urethro scrotal fistula catheter by filling it with radio-opaque dye

from the syringe.

! Urethritis The catheter is inserted in the anterior urethra

! Periurethral abscess (collection) for about one cm. The catheter is fixed in the

glans either with the penile clamp or it can be

kept fixed with two fingers of the doctor.

! Complete aseptic measures are adopted.

Gentle pull is applied to keep the complete The doctor scrubs up exactly the same way

as for any operation. The external genitalia length of penis and urethra stretched.

of the patient are cleaned with non irritant

ant i sept ic so lut ion (Sava lon or The dye is injected (5-10 ml) and x-ray picture

Chlorexidine). Sterile sheets are put on the is exposed immediately.

INDICATIONS

PROCEDURE

CONTRAINDICATIONS

PREPARATION

Retrograde urethrogram showing posterior urethral valves

A new method has been designed for urethral

studies, it is sono-urethrography (S.U). It is

much better in detection of anterior urethral

strictures than x-ray urethrography. It is The x-ray pictures are exposed in two dimen-

slightly less efficient in the detection of sions (antero-posterior view and lateral view).

1

posterior and bulbar urethral strictures . Not

only the whole length of stricture is seen but The x-ray films are developed to see the

extent of periurethral fibrosis is also seen with quality of film and if acceptable, the patient is

this method of examination.sent home or to the ward.

Sono-urethrography is used for an accurate The urethrogram shows all parts of male

prediction of stricture length. It shows clearly urethra very clearly. It also shows stricture,

periurethral strictures including the urethral diverticulae and urethral valves, false pas-

wall, corpus spongiosum, corpus cavernosa, sages or any other abnormality if present.2

bulb and external urinary sphincter . It is

It also shows the exact nature, site and the unsatisfactory in detection of membranous

size of stricture and helps in the assessment urethral stricture.

and management of the patient. It shows the

This investigation is not very helpful for nature of the rupture urethra whether com-

posterior urethral strictures.plete, partial or just bruising, it also shows

false passages, tumours or stones or foreign

bodies if present in the urethra.

SONO-URETHROGRAPHY


Urethrography 3

Retrograde urethrogram showing stricture of the penile urethra

Urethrogram showing stricture of anterior urethra

Sono-urethrogram of the same patient with stricture

of anterior urethra


Urethrography 4

REFERENCES tures.

1. Fernandez Fernandez A. Ramirez

3. Correlation with radiolographic Esteban A. et al. Diagnostic efficacy of

urethrography Jcu. Journal of clinical echographic urethrography in the

ultrasound. [JC:htv] 21(4): 231-9, study of urethral stenosis. Comparison

1993 May.with radiologic retrograde urethro-

graphy. Actas urologic as Espanolas

4. Juan D Berna-Mestre Jr JD Berna-[JC:2al] 16(8): 627-30, 1992 Sep.

Serna. A perfected device for perform-

ing retrograde urethrography. Medical 2. Gupta S. Majumdar B. Tiwari A. Gupta

devices: Evidence and research RK. et al. Sono-urethrography in the

2008:1 19-21.evaluation of anterior urethral stric-

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013 191 urethrography

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