Retrograde urethrography (RUG) is generally and commonly done in male patients as they have a longer and more complex urethral pathway
The genitourinary system is divided into the upper urinary tract (kidneys, ureters), the lower urinary tract (bladder, urethra), and external genitalia (penis, scrotum, testes)
Trauma to the urinary tract accounts for about 10% of all injuries seen in the emergency department
Early clinical suspicion, appropriate and reliable radiologic studies, and prompt surgical intervention, when indicated, are the keys to successful diagnosis and management
INDICATIONS
Blood at the urethral meatus
Abnormal position of the prostate on rectal examination
Perineal ecchymosis
Scrotal ecchymosis
Blood from the introitus/vaginal vault
CONTRAINDICATIONS
No absolute contraindications exist
LANDMARKS
The dome of the bladder is covered by peritoneum, and the bladder neck is fixed to neighboring structures by reflections of the pelvic fascia and by true ligaments of the pelvis
In males, the bladder neck is contiguous with the prostate, which is attached to the pubis by puboprostatic ligaments
In females, pubourethral ligaments support the bladder neck and urethra
The body of the bladder receives support from the urogenital diaphragm inferiorly and the obturator internus muscles laterally
EQUIPMENT
Radiopaque contrast material
X-ray machine or fluoroscope machine
16-French or 18-French Foley catheter
Catheter tip syringe
5-mL syringe to fill the Foley catheter balloon
General Basic Steps
Prepare 10% contrast solution
Insert syringe or Foley in urethral meatus
Inject contrast slowly
X-ray (urethrogram)
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