This paper seeks to introduce an alternative novel retrograde urethrograms (RUG) technique in the imaging of urethral strictures that is less complicated, easier to perform, and produces consistently technically adequate diagnostic images of the urethra with lower patient discomfort.

RUGs are the current gold standard in identifying urethral strictures to achieve accurate diagnosis, staging, and pre-operative planning.1-9 The Foley catheter method introduced by McCallum in 19796 has been considered the conventional method in performing RUG. The method involves insertion of a 14 French foley catheter followed by insufflation of the balloon with saline in the fossa navicularis and the injection of contrast.2,4 Commonly proceduralists may choose to use lubrication with or without an anaesthetic component.10 Common complications associated with the Foley method include pain...

This novel RUG technique substitutes the utilization of a Foley catheter for a 21 Gauge IV cannula and clamp (Figure 1) to overcome the shortcomings of the Foley catheter method. It enables maximum traction, and thus elongation of the anterior urethra to identify strictures including its precise location and length. The size of the IV cannula in comparison to the Foley catheter minimizes patient discomfort allowing for maximum traction and allows for RUGs to be performed for patients with distal urethral abnormalities that otherwise would...

An alternative novel RUG technique is described to allow the proceduralist to obtain consistent technically adequate RUGs and to resolve the shortcomings of the Foley catheter method. The next step would be to complete a study comparing the two methods in terms of rate of technically adequate RUGs and diagnostic accuracy within the same patient population and health service.

Maciejewski C, Rourke K. Imaging of urethral stricture disease. Transl Androl Urol. 2015;4(1):2-9. doi:10.3978/j.issn.2223-4683.2015.02.03 Kim B, Kawashima A, LeRoy AJ. Imaging of the Male Urethra. Seminars in Ultrasound, CT and MRI. 2007;28(4):258-273. doi:https://doi.org/10.1053/j.sult.2007.05.003 https://www.sciencedirect.com/science/article/pii/S0887217107000455 Alwaal A, Blaschko SD, McAninch JW, Breyer BN. Epidemiology of urethral strictures. Transl Androl Urol. 2014;3(2):209-213. doi:10.3978/j.issn.2223-4683.2014.04.07 Ayoob A, Dawkins A, Gupta S, Nair R. Anterior urethral strictures and retrograde urethrography: An update for radiologists. Clinical Imaging. 2020;67:37-48. doi:https://doi.org/10.1016/j.clinimag.2020.05.008 https://www.sciencedirect.com/science/article/pii/S0899707120301613 Gallentine ML, Morey AF. Imaging of the male urethra for stricture...