Novel pericatheter retrograde urethrogram technique is a viable method for postoperative urethroplasty imaging

Area of Science:

• Urology
• Radiology
• Surgical Outcomes

Background:

• Urethral reconstruction requires accurate assessment of healing to prevent complications.
• Traditional methods like voiding cystourethrography and retrograde urethrography have limitations.
• A minimally invasive technique is needed to evaluate urethral integrity post-surgery.

Purpose of the Study:

• To describe the technique of pericatheter retrograde urethrogram (pcRUG).
• To evaluate the utility of pcRUG in detecting clinically significant leaks after urethral reconstruction.
• To assess the safety and reproducibility of the pcRUG procedure.

Main Methods:

• Retrospective review of patients undergoing urethral reconstruction with IRB approval.
• Standardized pcRUG performed 3-4 weeks post-surgery under dynamic fluoroscopy.
• Diluted contrast instilled via angiocatheter alongside the urethral catheter to detect extravasation.

Main Results:

• 144 pcRUGs performed on 130 patients between September 2012 and February 2017.
• No extravasation observed in 88.5% of patients; 11.5% showed extravasation.
• Extravasation correlated with panurethral strictures (p=0.029) and length ≥10 cm (p=0.016).
• One case of urinary leak and scrotal abscess occurred after presumed healing; no other complications reported.

Conclusions:

• Pericatheter retrograde urethrogram is a safe, reproducible, and effective technique for assessing urethral healing.
• pcRUG accurately determines the optimal timing for urethral catheter removal post-reconstruction.
• The method is minimally invasive and comparable in accuracy to traditional urethrography techniques.