Radiography: vaginourethrography

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

Introduction

  • Allows visualization of vagina and urethra.

Uses

  • Investigation of lower urinary tract disease:
    • Ectopic ureters Ureter: ectopic.
    • Dysuria.
    • Hematuria Hematuria.
  • Investigation of vaginal discharge.
  • Investigation of urinary incontinence Urinary incontinence.
  • Investigation of physical vaginal abnormalities, eg neoplasia Urethra: neoplasia stricture - retrograde vaginourethrogramVagina: neoplasia - retrograde vaginourethrogram stenosis.

Advantages

  • Simple and quick to do.

Disadvantages

  • Requires general anesthesia General anesthesia: overview.

Preparation

  • 15 min.

Requirements

Materials required

Minimum equipment

  • X-ray machine.
  • Radiographic cassette.
  • Processing facilities.
  • Protective clothing (lead apron) for radiographer.
  • Positioning aids (sandbags 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.
  • Tongue clamps or Allis tissue forceps.
  • Vaginal speculum may be helpful for bladder catheterization in bitch.

Minimum consumables

  • Radiographic film.
  • Contrast agent.
  • Syringe.
  • Three way stopcock.
  • Foley catheter.
    If patient is a very small dog, an angiographic, flow-directed balloon-catheter, eg Swan-Gante, may be used because of smaller gauge. (May have access to this type of catheter through a radiology department of a local human hospital.
    To prevent tip of catheter occluding urethral orifice cut tip off Foley catheter beyond bulb but ensure bulb of catheter still inflates

Sequelae

Reasons for treatment failure

  • Failure to seal vulval lips results in leakage of contrast and inadequate filling of vagina and urethra.

Sources

Publications

  • Holt P E, Gibbs C & Latham J (1984) An evaluation of positive contrast vaginourethrography as a diagnostic aid in the bitch. JSAP 25 , 531-549.
  • Johnston G R, Stevens J B, Jessen C R & Osbourne C A (1983) Complications of retrograde contrast urethrography in dogs and cats. Am J Vet Res 44 , 1248-1255.
  • Feeney D A, Thrall D E, Barber D L, Culver D H & Lewis RE (1979) Normal excretory urogram - effect of dose, time and individual dog variations. Am J Vet Res 4 , 1596-1604.

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