Name of the Procedure:

Injection procedure and placement of chain for contrast and/or chain urethrocystography

• Common Names: Chain study, Urethral chain placement
• Technical Terms: Urethrocystography with chain, Contrast urethrocystography

Summary

This procedure involves the injection of contrast material into the urethra and bladder to visualize their structure through X-ray imaging. A chain may be inserted as a marker to enhance the clarity of the images.

Purpose

The procedure aims to diagnose and evaluate abnormalities in the urethra and bladder. It helps identify structural issues, obstructions, and other abnormalities that could affect urinary function.

Indications

• Recurrent urinary tract infections (UTIs)
• Suspected urethral stricture or obstruction
• Trauma to the pelvic area
• Symptoms such as pain or difficulty urinating
• Unexplained hematuria (blood in urine)
• Pre-surgical evaluation for certain urological procedures

Preparation

• Fasting is generally not required.
• Patients should inform the doctor of any allergies, especially to contrast dye or shellfish.
• Certain medications may need to be adjusted; consult the healthcare provider.
• A complete medical history and physical examination are performed.
• Pre-procedure imaging (e.g., ultrasound, CT scan) may be requested.

Procedure Description

1. The patient is positioned on an X-ray table.
2. Local anesthesia may be applied to the urethral area to minimize discomfort.
3. A contrast dye is gently injected into the urethra and bladder.
4. A thin chain is inserted into the urethra as a radiopaque marker.
5. X-ray images are taken to capture detailed views of the urethra and bladder.
6. The chain and any excess contrast material are removed after imaging.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

• Outpatient clinic
• Hospital radiology department
• Urology specialty center

Personnel

• Radiologist or urologist
• Radiology technician
• Nursing staff

Risks and Complications

• Mild discomfort or pain during injection
• Allergic reaction to contrast dye
• Infection at the site of injection (rare)
• Injury to the urethra or bladder (rare)
• Hematuria (rare and usually temporary)

Benefits

• Accurate diagnosis of urethral and bladder conditions
• Non-invasive imaging method
• Facilitates targeted treatment planning
• Provides critical information for surgical interventions

Recovery

• Patients can usually return to normal activities shortly after the procedure.
• Drink plenty of fluids to help flush out the contrast dye.
• Monitor for signs of infection such as fever, chills, or unusual discharge.
• A follow-up appointment may be necessary to discuss results and next steps.

Alternatives

• Ultrasound imaging
• CT scan with or without contrast
• MRI (Magnetic Resonance Imaging)
• Pros and cons: While alternatives may be less invasive or use different imaging modalities, they may not provide the same level of detail as urethrocystography with chain.

Patient Experience

• Mild discomfort or a sensation of pressure during the procedure is common.
• Some patients may feel a brief stinging sensation with the injection.
• Post-procedure, patients might experience mild urinary discomfort, which usually subsides quickly.
• Pain management typically involves over-the-counter pain relievers and adequate hydration.