Radiology procedure (R. G. U.)


 

The R.G.U. (Retrograde Urethrogram) is a radiological procedure used to evaluate the male urethra for strictures, trauma, or other abnormalities. It is typically done under fluoroscopy using contrast media to visualize the urethral lumen.

1. Full Form:

R.G.U. – Retrograde Urethrogram

2. Indications:

  • Suspected urethral stricture (e.g., from trauma, infection)
  • Evaluation of urethral trauma
  • Urethral diverticula or fistulas
  • Pre-operative assessment (e.g., before urethral surgery)
  • Post-operative assessment of urethral reconstruction
  • Recurrent urinary tract infections (UTIs) in males

3. Contraindications:

  • Active urinary tract infection (relative contraindication)
  • Recent urethral surgery (may delay due to risk of disrupting healing)
  • Acute inflammation or bleeding of the urethra
  • Allergy to iodinated contrast media (use precautions or alternative)

4. Contrast Used:

  • Water-soluble iodinated contrast media (e.g., Urografin, Omnipaque)
  • Usually non-ionic, low-osmolar contrast preferred to reduce irritation

5. Patient Preparation:

  • Informed consent
  • Ask about contrast allergy, renal function, and UTIs
  • Explain the procedure clearly to reduce anxiety
  • No need for fasting
  • May require mild sedation in anxious patients

6. Method / Procedure:

  1. Position the patient supine or oblique (usually 30° oblique to left).
  2. Clean the genital area aseptically.
  3. A sterile catheter (e.g., Foley) with balloon may be inserted just at the tip of the urethral meatus or a penile clamp may be used.
  4. The balloon is inflated slightly to seal the meatus (if catheter is used).
  5. Contrast is gently injected into the urethra under fluoroscopic control.
  6. Serial X-rays are taken during contrast injection to visualize the anterior urethra.

7. Taken Films:

  • Oblique views of the pelvis and penis (typically left posterior oblique)
  • Scout film before contrast
  • Films during and after contrast injection to show:
    • Penile urethra
    • Bulbar urethra
    • Membranous urethra (partially, unless voiding cystourethrogram is done)
  • Additional images if abnormalities are seen

8. After Care:

  • Encourage hydration to flush out contrast
  • Observe for signs of urinary retention or bleeding
  • Monitor for signs of urinary tract infection
  • No catheter usually left unless part of further treatment

9. Diseases Diagnosed by RGU:

  • Urethral stricture (most common)
  • Urethral trauma or rupture
  • Urethral diverticulum
  • Fistulae (e.g., urethrocutaneous, urethrorectal)
  • Calculi in the urethra
  • Congenital anomalies of the urethra
  • Urethral valves (in pediatric patients)


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