But it is associated with radiation exposure and underestimates the length of the stricture. Pain though is well tolerable, since proper preparation has preceded. This diagnostic test is commonly performed in male patients when narrowing of the urethra is suspected. Ascending urethrogram has been the gold standard investigation in the evaluation of stricture urethra. All about radiologists costs acc1521 october 16 page 1 of 5 effective 01 december 2018 acc information sheet this information sheet lists the cost of treatment regulations amounts acc can. Ultrasonographic evaluation of urethral stricture disease. The study commences with a scout film to assess bony structures as well as the presence of any calcified urinary tract pathology. Penile cavernosography can reveal lacerations that are not detected surgically, but is a painful and invasive procedure. Imaging of urethral stricture disease pubmed central pmc.
Hence to overcome these shortcomings of ascending urethrogram, ultrasound evaluation of stricture urethra called sono urethrogram has been tried. You will be asked to lie on your side on an xray table. Of course thats exactly what a voiding cystourethrogram is doing. Ascending and descending urethrogram vesicoureteric reflux is seen in decending urethrography the bladder is filling with contrast normally there is dilatation of proxinal posterior urethraincompetent posterior urethral valve no contrast is entering distal urethra. A urethrogam is a procedure which demonstrates the capacity of the bladder and its emptying ability and examines the urethra, the narrow tube which connects the bladder to the genitals through which urine passes before leaving the body.
Retrograde urethrogram procedure preparation md imaging. Its an antegrade urethrogram, which youll know by now means a picture of the urethra when urine is flowing the normal way. Introduction retrograde urethrography and voiding cystourethrography modalities of choice for imaging the urethra. Dhayanand 1 1 jss medical college and hospital, mysore, karnataka, india abstract.
Ask the patient to lie in supine position slightly tilted and legs position as shown in the video. Excellent resource for radiology residents, technologists, and radi. A urethrogram is an investigation that allows us to visualise the urethra the water pipe that. The procedure involves the insertion of a foley catheter into the distal urethra and minimally. A retrograde urethrogram is a routine radiologic procedure most typically in males used to. Normal retrograde urethrogram rug, followed by a normal voiding cystourethrogram vcug retrograde urethrogram. But they needed another name so it wouldnt you know. It is common in this situation to perform a urethrogram prior to catheter removal. Retrograde urethrogram what is a retrograde urethrogram. The penis is postioned at approximately the 10 oclock position. Urethrography refers to the radiographic study of the urethra using iodinated contrast media and is generally carried out in males. Urethrogram figures 1285 and 1286 is performed by placement of the tip of a foley catheter into the entrance of the urethra, followed by instillation of 50 ml of contrast under low pressure usually gentle hand injection or gravity. Psoas hitch boari bladder flap 50785 enterocystoplasty 51960 mitrofanoff procedure 50845 repair enterovesical fistula 44660 ileal conduit urinary diversion 50820 neobladder 51596 continent. A retrograde urethrogram allows us to evaluate any structural abnormalities in the urethra including narrowed areas strictures or contractures and outpouchings diverticulum.
Bladder prostate membranous urethra bulbar urethra penile urethra tip of penis these are the 3 projections that are taken during rgu procedure. A retrograde urethrogram is an xray examination of the urethra for men, which cannot be seen on a normal xray. The procedure is as follows pain though is well tolerable, since proper preparation has preceded. Retrograde urethrogram 51610 voiding cystourethrography 51600 suprapubic tube placement open or endoscopic 51010. This will show extravasation at the site of injury. Terminology when the urethra is studied with instillation of contrast into the distalanterior urethra it has be. The urethrogram is the oldest radiographic test for assessing urethral stricture disease, and remains the gold standard for diagnosis and staging 1,2. Step by step instructions on how to perform a retrograde urethrogram in an adult patient. A urethrogram is an examination of the urethra by xray imaging, almost always carried out on males. Overview a retrograde urethrogram rug is a diagnostic procedure performed most commonly in male patients to diagnose urethral pathology. A clear fluid or xray dye is used to outline the urethra so that it may be examined using xrays.
Sono urethrogram was more proceure and specific in diagnosing urethral stricture disease in our study as compared to ascending urethrogram. The indwelling catheter can be removed if the urethrogram appearances are acceptable. The initial experiences with ultrasound evaluation of the urethra. This test is done in a hospital radiology unit, operating room, or a providers office.
Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. The urethra is the tube that runs from the bladder through the prostate and penis. If a urethrogram or voiding cysto urethrogram is required, you will then be asked to empty your bladder into a container. If a urethrogram is not required, you will be free to use the washroom, get dressed and then leave the department. Hernadez retrograde urethrogram simulation youtube. Posttraumatic urethrography should include both an ascending. Patient should take nothing by mouth food or drink 4 hours prior to exam. Article in journal of the pakistan medical association 588. To compare the efficacy of sono urethrogram and ascending urethrogram in the evaluation of stricture urethra. Retrograde urethrogram is a routine radiologic procedure used to image integrity of urethra. Please arrive 15 min before your scheduled appointment time.
A urethrogram is usually carried out to show the cause of poor urinary flow thought. A nuclear medicine thyroid scan uses a radioactive medication radiopharmaceutical to take pictures or images of the thyroid gland. This slide shows normal radiographic anatomy on a normal oblique ascending urethrogram. If you have any questions about how to prepare for your study, please call md imaging at 5302431297. Most often, the urethrogram is performed in a retrograde fashion. 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 which carries urine from the bladder to outside the body. Evidence of ongoing contrast leak, complete urethral transaction or an evolving stricture should undergo appropriate urological management. This information sheet relates to the procedure being carried out on a male. The round opaque structure in the distal penis is the inflated foley balloon.
Eventhough sono urethrogram is also associated with similar complications, the incidence is less compared to ascending urethrogram. View and download powerpoint presentations on ascending urethrogram ppt. An uninjured urethra should show a smooth linear contour and filling of the bladder. Pdf on jan 10, 2017, v dola and others published ascending urethrogram and sonourethrogram in evaluation of male anterior urethra find, read and cite all the research you need on researchgate. The procedure uses a type of xray called fluoroscopic imaging to view images in real time. In this study, a significant association of length with etiology of stricture was observed p procedure used to visualize abnormalities of the urinary system, including the kidneys, ureters, and bladder. Following open reconstructive urethral surgery it is standard urological procedure to leave a urethral catheter insitu for a number of weeks whilst the repair heals. A urethrogram is a procedure used to show the location and characteristics of a clinically suspected urethral stricture, which is most often a result of trauma, surgery, prolonged catheterisation or radiation therapy. A combination of retrograde urethrogram rgu and voiding cystourethrogram vcug is done to define the site and length of urethral stricture. Comparison between ascending urethrogram and urethral ultrasound in the diagnosis and treatment of stricture. Comparison between ascending urethrogram and 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. Is ascending urethrogram mandatory for all urethral strictures. In ascending urethrography, your physician will infuse contrast medium into your bladder through a special catheter that will be placed to the outer urethral orifice during this phase, xrays will be taken at regular time intervals. Your doctor may refer you for this procedure if you have problems with poor urinary flow that the doctor thinks are not caused by the usual. Introduction urethrography is most commonly performed via the retrograde injection of radiopaque contrast into the urethra to elucidate urethral pathol. Dr alan list prof stacy goergen what are the generally accepted indications for a urethrogram. You will be asked to undress and put on a hospital gown. Find powerpoint presentations and slides using the power of, find free presentations research about ascending urethrogram ppt. Rgu test is a special xray procedure done to study urethra.
Ascending urethrography catheter tip syringe sterile drape the urethrogram will show if there is a problem in the urethra that. 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. A comparative study of ascending urethrogram and sono. Unlike a kidneys, ureters, and bladder xray kub, which is a plain that is, noncontrast radiograph, an ivp uses contrast to highlight the urinary tract. Is ascending urethrogram mandatory for all urethral.
Rguprimary imaging modality for evaluating traumatic injuries, inflammatory and stricture diseases of male urethra. The parameters analyzed included presentation of patients, ascending urethrogram aug and descending urethrogram findings, pre and postoperative international prostate symptoms score ipss, uroflowmetry q max, and postvoid residue pvr. These patients underwent different modes of treatment. If urethral compromise is suspected, then an ascending urethrogram is mandatory. Starting with description of urethrography in brief.
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