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Retrograde Urethrogram

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Retrograde Urethrogram, Retrograde Cystourethrogram

  1. Perineal or scrotal hematoma
  2. Blood at uretheal meatus
  3. High riding Prostate
  4. Pelvic Fracture or Pubic Symphysis Diastasis suspected
  5. Inability to void
  1. Insert 8 Fr Foley Catheter until balloon is inside the distal Urethra (1-2 cm)
    1. Gently inflate balloon with 1-2 cm saline or air (just enough to secure in place)
    2. Catheter-tip syringe may be used as an alternative to 8 Fr
      1. Secure by gently compressing glans (with hand) around catheter tip
  2. Hold the penis gently outstretched
  3. Slowly inject contrast via catheter
    1. Water-soluble contrast (e.g. omnipaque diluted to 10% with Normal Saline)
  4. Image with XRay or Fluoroscopy
    1. Perform imaging while injecting last 10 ml of contrast
    2. Obtain images in 2 opposing views (i.e. anteroposterior and lateral view)
  • References
  1. Herbert and Inaba in Herbert (2014) EM:Rap 14(3): 5-6
  2. Davis in Roberts (2014) Clinical Procedures in Emergency Medicine, 6th Ed, Saunders Elsevier, p. 1113-54