Name of the Procedure:

Retrograde Urethrocystography
Common name(s): Cystography, Retrograde Cystography

Summary

Retrograde urethrocystography is a diagnostic imaging procedure used to visualize the urethra and bladder. It involves injecting a contrast dye into the urethra to highlight the urinary structures for X-ray imaging.

Purpose

Medical Condition or Problem it Addresses:

• Identifying urethral strictures, injuries, and abnormalities.
• Diagnosing bladder injuries or conditions such as fistulas or diverticula.

Goals or Expected Outcomes:

• To provide detailed images of the urethral and bladder structures.
• To assist in diagnosing and planning appropriate treatments for urinary issues.

Indications

Symptoms or Conditions Warranting the Procedure:

• Difficulty urinating or painful urination.
• Blood in urine (hematuria).
• Repeated urinary tract infections.

Patient Criteria:

• Suspected urethral or bladder injuries.
• Evaluation prior to urological surgeries or interventions.

Preparation

Pre-procedure Instructions:

• Patients may be asked to fast for a few hours before the procedure.

• Antibiotics may be prescribed to prevent infection.

  Diagnostic Tests or Assessments:

• Routine blood and urine tests might be recommended.
• Allergy testing for contrast dye if needed.

Procedure Description

Step-by-step Explanation:

1. The patient lies flat on the X-ray table.
2. The genital area is cleaned and sterilized.
3. A catheter or special syringe is inserted into the urethra.
4. Contrast dye is gently injected into the urethra and bladder.
5. X-ray images are taken as the dye fills the urinary structures.
6. The catheter is removed once imaging is complete.

Tools and Equipment:

• Sterile catheter or syringe, contrast dye, X-ray machine.

Anesthesia or Sedation:

• Local anesthetic gel may be applied to the urethra for comfort.

Duration

The procedure typically takes about 30 to 45 minutes.

Setting

Usually performed in a hospital radiology department or an outpatient imaging center.

Personnel

Healthcare Professionals Involved:

• Radiologist performing the imaging.
• Urologist may assist or oversee the procedure.
• Nurses for patient preparation and support.

Risks and Complications

Common Risks:

• Mild discomfort or burning during urination post-procedure.
• Infection.

Rare Risks:

• Allergic reaction to the contrast dye.
• Urethral injury.

Complication Management:

• Antibiotics for infections.
• Immediate medical attention for severe allergic reactions.

Benefits

Expected Benefits:

• Accurate diagnosis of urinary tract issues.
• Improved treatment planning based on detailed imaging.

Realization of Benefits:

• Often immediate as the images are reviewed shortly after the procedure.

Recovery

Post-procedure Care:

• Drink plenty of fluids to help flush out the dye.
• Monitor for signs of infection such as fever and report any severe symptoms.

Expected Recovery Time:

• Typically, patients can resume normal activities almost immediately.
• Mild discomfort may last for a day or two.

Follow-up:

• Follow-up appointments may be scheduled to discuss the results.

Alternatives

Other Treatment Options:

• Ultrasound imaging.
• MRI of the urinary tract.

Pros and Cons of Alternatives:

• Ultrasound: No radiation exposure but less detailed.
• MRI: High detail without radiation but more expensive and not always available.

Patient Experience

During the Procedure:

• Mild discomfort or pressure when the catheter is inserted.
• Cold sensation as the contrast dye is injected.

After the Procedure:

• Possible burning sensation during urination.
• Fluid intake is encouraged to alleviate discomfort and flush out the dye.

Pain Management and Comfort Measures:

• Local anesthetic gel for the urethra.
• Over-the-counter pain relief if needed post-procedure.