What Is a Retrograde Urethrogram?

Retrograde urography is an important examination method in urology. Retrograde angiography should not be performed when there is urethral stricture, prostatic hyperplasia, recent lower urinary trauma, or diseases where cystoscopy is contraindicated during surgery.

Retrograde urography

Dissatisfied with upper urography during excretory urography due to various reasons

Intestinal preparation is required before imaging (generally, laxatives need to be taken orally before the filming or clean enema before filming to empty the gas and feces in the intestine to obtain a satisfactory image). At the beginning of the inspection, a cystoscopy is performed, and then a ureteral catheter is inserted into the ureter. A plain film of the urinary tract is taken to observe whether the position of the ureteral catheter is appropriate. After confirming that the position is appropriate, the contrast agent is injected into the ureteral catheter. Generally speaking, the degree of soreness in the patient's waist when injecting medicine is taken as the degree, and the film should be read in time after taking the film.

1 .; 2. Various stones in the urinary tract can be observed; 3. Contrast angiography has a high concentration, which is especially suitable for those with renal insufficiency and non-ideal method.

1. Cannot understand renal perfusion and excretion functions; 2. Aseptic operation is required, and technical difficulties are high; 3. Lower urinary tract and urinary tract infections are not suitable for this test; 4. The diagnosis of renal space occupying is similar to venography .

[Effects on the urethra and bladder] This method has an irritating effect on the urethra and bladder mucosa and edema occurs. In physical experiments, this change peaked at 48 hours and lasted for at least a week. Diluting the contrast medium and injecting a small amount of low pressure into the bladder can reduce the inflammatory response in the bladder. The irritation of diatrizoic acid in clinical use seems to be less than that of acetobenic acid.

[Effects on the kidney] Retrograde pyelography can cause renal dysfunction with acute renal failure, especially when there is a significant pelvic-renal reflux, which can cause death. When using barium sulfate for cystography, ureteral reflux can occur, and barium can be concentrated in the calamity of the kidney, causing a granulomatous reaction with fibrosis.

[Periodic effect] In patients who are sensitive to contrast agents, the application of retrograde pyelography is much safer than intravenous pyelography, but a small amount of contrast agent can be absorbed through the calorimeter. In a patient with pelvic-renal reflux, 12.5% of the contrast medium was absorbed. It is rare for urinary tuberculosis to develop miliary tuberculosis with retrograde pyelography accompanied by pelvic vein reflux.

[Additional effects] Retrograde pyelography often contains some additional substances, such as surfactants, dextran, local anesthetics and antibiotics. The concentration of neomycin in some contrast agents is 2.5%. When mixed with a catheter lubricant containing sodium alginate, precipitation may occur and coagulate in the bladder. Neomycin in the contrast agent can also cause temporary paralysis due to neuromuscular blockade, causing patients with congenital defects to experience extravasation of the contrast agent in the peritoneum.