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Among the existing ailments of the genitourinary system, one of the most common are diseases of the urethra. This pathology affects both men and women. Most often we are talking about changes in the structure of the urethral wall, resulting from the inflammatory process. The success of therapy directly depends on the timeliness of the diagnosis and the chosen method of treatment.
A patient who turns to a specialist with complaints of pain in the lower abdomen or difficulty urinating may be prescribed urethrography. In other words, this is an x-ray with the use of a contrast agent.
Operating principle
An x-ray of the urethra can be prescribed for both men and women. The essence of the method of urethrography is the transmission of x-rays through the area of the body under study. Since soft tissues transmit rays well, the urethra must be filled with a contrast agent.
Given the anatomical features, in most cases, an x-ray of the urethra in men and women is the only way to examine the condition of the urethra and establish the correct diagnosis.
There are two types of urethrography – descending and ascending. In the first case, the contrast enhancer is injected directly into the bladder and then spreads through the urethra. In this case, the anterior part of the urethra is clearly visible in the picture. With ascending urethrography, contrast is injected directly through the urethra – the method helps to visualize the back of this organ. To obtain a complete clinical picture, both types of diagnostic methods are usually combined.
What will urethrography show?
There are many types of pathologies of the urethra. X-ray of the urethra with the use of a contrast agent allows the doctor to assess the condition of damaged organs and develop an effective treatment method. On the picture, you can see stones, tears, cysts, saccular protrusions, fistulas, tumors, strictures and other congenital and acquired anomalies in the structure of the urethra.
An x-ray is necessarily performed at the time of urination – in this way it is possible to achieve complete filling of the urethra with a contrast agent.
A referral for research can be issued not only by a urologist, but also by a surgeon, oncologist or nephrologist. Deciphering the obtained images is the task of the radiologist. The same specialist is obliged to issue a conclusion on the basis of which the attending physician can establish a diagnosis.
Indications for urethrography
Patients suffering from urinary disorders go to a doctor who can issue a referral for an x-ray of the urethra in order to determine the cause of the pathology. Other indications for the appointment of the procedure are:
- neoplasms in the urethra, provoking its deformation;
- foreign objects in the urethra;
- stones;
- violation of the integrity of the urethra, narrowing of the lumen;
- certain chronic or infectious diseases of the bladder;
- violations of the structure of the urethra.
It is preferable to undergo the procedure in a specialized medical institution equipped with the necessary equipment. In addition, much depends on the experience and professionalism of the radiologist conducting the radiograph and deciphering the images.
Preparation for research
Urethrography is a minimally invasive diagnostic method. That is, the procedure requires intervention in the body, but incisions and other radical methods are not used. Since the patient will experience discomfort during the injection of contrast, it is important to start taking sedatives a few days before the procedure. Immediately before the urethrography, an anesthetic is administered.
Before the introduction of contrast, the patient must completely empty the bladder.
Features of the procedure
Urethrography techniques for men and women are different. It is technically more difficult to investigate the condition of the urethra of a woman due to the physiological characteristics of the body.
Urography is necessarily preceded by an x-ray of the bladder and urethra in the anteroposterior projection. If there is a suspicion of damage to the integrity of the urethra, an x-ray of the pelvic bones should be taken.
Urethrography in men
The patient should expose the lower part of the body. He lays down on the couch on his side. An important condition is that the urethra should be directed to the thigh. Before the introduction of a contrast agent, the head of the penis must be treated with an antiseptic. To facilitate the process of introducing contrast and obtaining clear images, the patient must follow the instructions of the specialist and take the correct position – the left leg is bent and shifted slightly back, the right leg is straight. A special syringe with a rubber tip is used to inject the contrast agent. At the time of the procedure, the man is obliged to keep the sexual organ in an upright position.
Urethrography in women
The patient exposes the lower part of the body and lies on the couch on her back, her legs are bent at the knees. To conduct a contrast enhancer, a special catheter with a pair of balloons is used – this makes it possible to simultaneously close the internal and external openings of the urethra.
The volume of the contrast agent injected into the patient’s urethra and bladder is 150-200 ml.
Contra-indications and limitations
Before the urethrography procedure, a test for the body’s sensitivity to a contrast agent is mandatory. If an allergic reaction occurs, this diagnostic technique cannot be applied.
If the patient has acute inflammatory processes in the urinary tract, urethrography is contraindicated. The procedure can be performed only after the course of treatment aimed at eliminating foci of inflammation.
This study is contraindicated for pregnant women.