A retrograde urethrogram is an X-ray procedure to examine the urethra, often done after trauma in men. A dye is injected into the urethra and the movement is evaluated to check for damage or narrowing. Women can also be tested.
A retrograde urethrogram is an X-ray procedure done to examine the integrity of the urethra, a part of the lower urinary tract. Typically the procedure is done in men after they have been subjected to blunt force trauma, but it can also be done in women. In the procedure, a dye is injected into the urethral opening, and the movement of the dye in the bladder is evaluated using X-rays. Although the test is most often done in the context of trauma, it can also be done to look for a narrowing of the diameter of the urethra.
The basic idea of performing a retrograde urethrogram is to visualize the urethra, which is the anatomical structure that carries urine from the bladder to the outside of the body, enabling humans to urinate. With this x-ray procedure, a dye is injected into the urethral opening and enters the body in the opposite direction that urine normally flows. An x-ray of the lower pelvic region is taken, which allows the dye to be visualized. A normal test would show the progression of the dye from the lower urethra down to the bladder, filling the bladder with the contrast material.
An abnormal retrograde urethrogram result would suggest that damage has been done to the urethra. On radiography, dye may leak out of the normal course of the urethra, suggesting that the wall of this tubular structure has been disrupted. In some cases, the dye may never reach the bladder, also suggesting that there was damage to the urethra.
One of the most important reasons a retrograde urethrogram is performed is in the context of acute trauma. The test is done more frequently in men because they have a higher risk of sustaining damage to the urethra, as these structures are much longer in men as their urethras must run the length of the penis. In some cases, however, women may also be tested to make sure they have no damage to this crucial structure. Clinical findings suggesting that this radiological procedure should be performed include bleeding at the opening of the urethra, finding bruises or hematomas in the skin overlying the urethra, or observing a high or swampy prostate in men while performing a rectal exam.
Another reason a retrograde urethrogram might be done is to look for strictures, or narrowings, in the urethra. Strictures can develop from a chronic infection, from living with a catheter placed inside the urethra for an extended period, or from undergoing radiation therapy as part of a cancer treatment regimen. Symptoms associated with the development of strictures may include straining to urinate or feeling like there is incomplete bladder evacuation.
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