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) 271 www.indepreviews.com
Urethrography
Indep Rev Apr-June 2012;14(4-6)
IR-191
M. Shuja Tahir
Key words: Urethrogram, Strictures urethra, Periunethral abscess.
Independent Review Vol:14: No:2 (271-274) 272 www.indepreviews.com
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 i c sol ut i on ( Saval on 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
Independent Review Vol:14: No:2 (271-274) 273 www.indepreviews.com
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
Independent Review Vol:14: No:2 (271-274) 274 www.indepreviews.com
Urethrography 4
REFERENCES tures.
1. Fernandez Fernandez A. Ramirez
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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-