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Retrograde Urethrogram
Aka: Retrograde Urethrogram, Retrograde Cystourethrogram
- Indications: Suspected Urethral Trauma (perform prior to Foley Catheter placement)
- Perineal or scrotal hematoma
- Blood at uretheal meatus
- High riding Prostate
- Pelvic Fracture or Pubic Symphysis Diastasis suspected
- Inability to void
- Technique: Bedside Emergency Department Procedure (where urology not available)
- Insert 8 Fr Foley Catheter until balloon is inside the distal Urethra (1-2 cm)
- Gently inflate balloon with 1-2 cm saline or air (just enough to secure in place)
- Catheter-tip syringe may be used as an alternative to 8 Fr
- Secure by gently compressing glans (with hand) around catheter tip
- Hold the penis gently outstretched
- Slowly inject contrast via catheter
- Water-soluble contrast (e.g. omnipaque diluted to 10% with Normal Saline)
- Image with XRay or Fluoroscopy
- Perform imaging while injecting last 10 ml of contrast
- Obtain images in 2 opposing views (i.e. anteroposterior and lateral view)
- References
- Herbert and Inaba in Herbert (2014) EM:Rap 14(3): 5-6
- Davis in Roberts (2014) Clinical Procedures in Emergency Medicine, 6th Ed, Saunders Elsevier, p. 1113-54