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The development of modern medicine does not stand still, due to which more and more new and very effective diagnostic methods appear. This progress has not bypassed such a vast field of medicine as urology. Currently, a large number of different methods are used to study the functioning of the genitourinary system and the state of the urinary tract. One of the most valuable and informative techniques is urethrography – the study of the urethral tract using X-ray examination.
The essence of the technique and indications for its implementation
The name of this method comes from the Greek words “urēthra”, which means urethra, and “graphō” – to depict.
This procedure is a method of examining the urethra, in which a specialized X-ray contrast agent is introduced into its cavity, thanks to which it is possible to determine the condition of the urethral tract. The main goal of this study is to effectively assess the patency of the urinary canal.
With this method of diagnosis, serious diseases that affect the organs of the genitourinary system are also detected. This technique is most often used in males, since the male urethral canal has a more complex structure.
Indications for this procedure are various diseases and pathological conditions of the organs of the genitourinary system. These include: stricture of the urethra, injuries of the urinary canal, benign and malignant neoplasms of the prostate gland, impaired urination, inflammatory processes in the urethra, prostate and bladder, as well as anomalies and pathologies of the development of the urethral tract.
Carrying out urethrography for the above diseases makes it possible not only to correctly diagnose, but also to identify the form and severity of the disease, to prescribe the appropriate method of therapy, characteristic of a particular type of disease.
Contraindications for diagnostics
In some cases, carrying out such a diagnostic method can lead to a deterioration in the patient’s condition, and therefore urethrography has a number of contraindications. It is strictly forbidden to conduct such an X-ray examination in the presence of the following diseases:
- severe allergic reactions in history;
- individual intolerance to iodine-containing substances;
- acute forms of purulent-inflammatory processes in the pelvic organs, as well as in the internal and external genital organs.
With the development of inflammatory processes, before conducting urethrography, the acute stages of this condition should be stopped and the diagnosis should be postponed to a later period.
Types of urethrography
In modern medicine, two types of this diagnosis are distinguished, each of which has its own advantages and helps to identify pathologies of the urogenital sphere. There is voiding urethrography, otherwise called descending, and retrograde urethrography, otherwise ascending.
With retrograde urethrography, the patient should be in the supine position. A special catheter is inserted through the glans penis into the urethral canal, with the help of which the urethra is filled with a contrast radiological substance. The most popular in this regard are iodine-containing substances such as hypak or urographin. With this type of diagnosis, a Janet syringe with a volume of one hundred milliliters is used.
The patient lies on his back, bending the right leg at the knee and hip joint. The left leg must be taken back, while leaving it in a straight position. This position allows you to most accurately reproduce the visualization of the urethra and achieve a clear contrast. In this case, it is necessary to fix the outer part of the penis in a straightened position.
This diagnosis is carried out using X-ray equipment, while the picture is taken at the moment when the urethra is completely filled with a radiopaque substance.
It is also necessary to know that during the normal procedure, the bladder is also filled with such a contrast agent.
With descending urethrography, a significantly greater presence of pathological processes in the urogenital tract can be detected. The catheter with this type of diagnosis is not installed in the urethra itself, as with ascending urethrography, but in the bladder. After that, about two hundred milliliters of a contrast agent is injected into it. Voiding urethrography is performed at the time of urination of the patient. Such diagnostics allows visualization of the full anatomical structure of the urethral canal, as well as an assessment of urination.
Descending urethrography best identifies pathologies located in the posterior urethra, and this makes it possible to diagnose urethral diverticulum, as well as some congenital anomalies associated with urethral valves and duplication.
What diseases can be detected by urethrography
This diagnostic method is aimed at identifying various types of anomalies and pathological processes occurring in the genitourinary tract. The most diagnosed diseases using this technique are bladder neck sclerosis, urethral injuries, oncological neoplasms of the bladder, urethra and adjacent organs, congenital pathologies of the urethra, primary and secondary deformities in the urethral canal.
Summing up
Urethrography is one of the most modern and most effective methods for diagnosing diseases of the urethra, genitals and urethra. This technique has practically no contraindications, and therefore is very popular. In some cases, such a study is the only possible way to identify pathologies of the urogenital tract. This procedure is applicable to both male and female patients.