Type:
Educational Exhibit
Keywords:
Abdomen, Pelvis, Urinary Tract / Bladder, Digital radiography, Experimental, Fluoroscopy, Contrast agent-other, Cystography / Uretrography, Other
Authors:
D. Luong, O. Wood, M. Benn, D. Desai
DOI:
10.26044/ranzcr2023/C-249
Background
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 and urethral bleeding secondary to rapid and/or excessive insufflation of the balloon and/or malposition of the balloon.10 The Foley method is prone to extravasation of contrast if the balloon is insufficiently inflated and balloon slippage out of the fossa navicularis upon hand injection with expulsion of the catheter from the penis altogether, which is exacerbated by lubricant use. Inherent difficulty in maintaining Foley catheter position and in the setting of patient discomfort, traction required to elongate the anterior urethral structures is severely limited, and therefore the ability to produce a technically adequate study.10-14 Furthermore, in distal urethral strictures that involve the fossa navicularis, insufflation of the balloon is not possible and in some cases, insertion of the Foley catheter is entirely precluded and the RUG abandoned. Prior to the introduction of the Foley catheter method, RUG was performed using an elaborate syringe and penile clamp device since 1910.10,15,16