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Retrograde Urethrogram or a Venogram? Be Careful Next Time
S Sharma1, Mayank Mohan Agarwal2, U K Mete2
1Department of Urology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India 160012 ; Department of Urology, Advanced Urology Center, Nehru Hospital, PGIMER, Level II, B Block, Sector 12, Chandigarh, India 160012.
Abstract:
Retrograde urethrogram is employed for adequate demonstration of anterior urethral stricture and is commonly performed by trainee residents. Not uncommonly, contrast is injected under pressure to overcome the resistance of a stricture which can lead to extravasation or intravasation exposing the patient to risk of bacteremia, sepsis, contrast reactions, and worsening of stricture. We report two such cases of extensive intravasation delineating the "venogram" of peno-pelvic venous arcade. Such rare occurrences highlight the importance of eliciting history of various allergies and asthma, urethral instrumentation, obtaining sterile urine before the study, and performing the study under dynamic fluoroscopy.