Retrograde urethrogram


A retrograde urethrogram is a routine radiologic procedure used to image the integrity of the urethra.
Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture.

Process

The procedure involves the insertion of a Foley catheter into the distal urethra and minimally inflating it. This is followed by instillation of 30mL of water-soluble contrast and a plain radiograph is obtained; leakage of the contrast suggests urethral injury and is an indication for surgical intervention.
It is used when there is suspicion of urethral trauma, such as a history of trauma to the area followed by pain, inability to void urine, or the presence of blood at the urethral meatus, a scrotal hematoma, or free-floating prostate on rectal examination.
If a urethral injury is suspected, a retrograde urethrogram should be performed before attempting to place a Foley catheter into the bladder. If there is a urethral disruption, a suprapubic catheter should be placed.