Radiography: urethrography

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Sections available in full article Introduction, Uses, Alternative techniques, Time required, Decision taking, Requirements, Personnel, Materials required, Preparation, Procedure, Aftercare, Immediate Aftercare, Sequelae, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s), Organization(s),
Contributors Dr Barbara J Watrous DVM DipACVR (Professor Emeritus)

Introduction

  • Radiography following injection of contrast into urethra.
  • Allows visualization of urethra.

Uses

  • Investigation of dysuria.
  • Investigation of hematuria Hematuria of suspected lower urinary tract origin.
  • Investigation of urinary obstruction, eg urethral calculi Urethra: calculi (male) - radiograph lateral.
  • Allows identification of patency of urethra Urethra: obstruction.
  • Assessment of presence of urethral disease.
  • Post-trauma, allows identification of urethal rupture Urethra: rupture.
  • Investigation of urinary incontinence Urinary incontinence.
  • May give information on bladder disease if unable to pass catheter due to urethral obstruction Bladder: neoplasia - radiograph.
  • Investigation of prostatic disease Prostate disease.

Disadvantages

  • May not identify functional urethral obstructions, eg urethral spasm, reflex dyssynergia.

Preparation

  • 5 minutes to collect materials.

Requirements

Materials required

Minimum equipment

  • X-ray machine.
  • Cassette.
  • Processing facilities.
  • Protective clothing (lead apron) for radiographer.
  • Lead sleeves and gloves for radiologist because of exposures made during injection.
  • Positioning aids (sandbags, cradle and ties).
  • Method of labelling film.

Ideal equipment

  • Ability to process films during procedure so that repeat radiographs can be taken during course of study if required.
  • High output x-ray machine.
  • High definition screen.
  • Grid for examination of large dog.

Minimum consumables

  • Radiographic film.
  • Urinary catheter (can use a paediatric Foley catheter 5 F).
  • Water soluble positive contrast agent.
  • Atraumatic (tongue) clamp.
  • Syringe.
  • Sterile water soluble lubricant (KY jelly).

Sequelae

Reasons for treatment failure

  • May get leakage of contrast backwards if end of urethra not occluded → contrast contaminating haircoat.
  • May not identify functional obstructions.

Sources

Publications

  • Johnson G R et al(1983) Complications of retrograde contrast urethrography in dogs and cats. Am J Vet Res 44 , 1248-1256.
  • Barsanti J A, Crowell W, Lesonsky J & Talkington F D (1981) Complications of bladder distention during retrograde urethrography. Am J Vet Res 42 (5), 819-821.
  • Ackerman N (1980) Use of the pediatric Foley catheter for positive-contrast retrograde urethrography. Mod Vet Pract 61 (8), 684-686.
  • Ticer J W, Spencer C P & Ackerman N (1980) Positive contrast retrograde urethrography - a useful procedure for evaluating urethral disorders in the dog. Vet Radiol 21 , 2-11.

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