RETROGRADE URETHROGRAM

Materials

    • Radiocontrast Angiograffin (dilute to half strength with saline)
    • 60 ml Toomey (Bladder) syringe
    • Christmas Tree adapter

 

Method

    • Preliminary KUB
    • Retract and secure foreskin with gauze and grasp penis with ring and middle finger of non-dominant had
    • Hold penis toward one side over thigh. Keep stretched to remove urethral folds.
    • Using dominant hand, insert contrast filled syringe with Christmas Tree adapter to meatus (achieve snug fit by squeezing glans with thumb and index finger of non-dominant hand)
    • Inject 50ml contrast slowly and gently (do not spill onto patient!)
    • Inject last 10ml and simultaneously take AP film of lower pelvis +/- supine obliques

Interpretation

    • Examine for flame-like density outside of urethral contour

 

RETROGRADE CYSTOGRAM

Materials

    • Radiocontrast Angiograffin (dilute to half strength with saline)
    • 60 ml Toomey (Bladder) syringe with plunger removed
    • 60 ml Toomey (Bladder) syringe with contrast

 

Method

    • Insert IDC (only if urethrogram is normal)
    • Preliminary KUB
    • Remove plunger from syringe, attach to IDC and hold above patient
    • Pour 100ml contrast into syringe
    • Take AP film if extravasation then cease further contrast
    • Pour 400ml contrast into syringe (if filling stops early then add additional 50ml with syringe by slow injection and stop)
    • Take AP film +/- supine obliques
    • Drain bladder
    • Take final AP film

Interpretation

    • Extravasation lateral to bladder = extraperitoneal rupture
    • Extravasation in paracolic gutters or outlines bower, liver or spleen

= intraperitoneal rupture

 

 

 
Disclaimer: Note: The information described here relates solely to operational matters in the Emergency Department.  Every effort has been made to verify the accuracy of the content. However, neither the author or the hospital will take responsibility for errors resulting from its use.  Please refer to your own departmental guidelines and verify all clinical decisions with a reliable source.  

Date Last Reviewed: 05/08/2004