Venous intravasation in retrograde urethrography

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Old trauma.

Patient Data

Age: 60 years
Gender: Male

Retrograde urethrogram reveals a segment of irregular stricture involving the bulbar urethra, with extensive urethro-venous intravasation.

Some of the contrast has intravasated into the corpora cavernosa. while some of it has entered draining veins. Contrast has also begun to fill the bladder; the posterior urethra appears narrowed, but is not sufficiently distended for evaluation.

Case Discussion

Venous intravasation in retrograde urethrography is associated with pre-existing mucosal breaches in inflammatory strictures when contrast enters submucosal venous plexus and intravasation along the venous pathway. Intravasation is partly due to the degree of pressure applied during contrast administration -- the higher the pressure, the more likely intravasation will occur.

 

It should reminded that iodinated contrast into the venous circulation may lead to an allergic reaction in susceptible individuals (up to and including anaphylaxis). Consider stopping the procedure when encountering intravasation.

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Case information

rID: 61673
Published: 13th Jul 2018
Last edited: 14th Aug 2019
System: Urogenital
Inclusion in quiz mode: Included
Institution: Tabesh medical imaging center

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