Diagnosis of urethral stricture
The contrast is gently injected with a syringe into the urethra and fills it to the bladder; images in an oblique projection show the lumen of the hanging, bulbous and membranous sections: narrowing, its length (a key parameter - short strictures up to 1-2 cm are suitable for internal urethrotomy, long ones require plastic surgery), swelling in case of injury. The examination is often combined with a voiding phase to evaluate the posterior urethra. Performed with sterile urine; after - drink plenty of fluids and, if necessary, a prophylactic dose of antibiotic.
Indications
- urolithiasis - overview image to control X-ray positive stones;
- hydronephrosis, anomalies of the kidneys and ureters - excretory urography;
- urethral stricture, urethral trauma - urethrography;
- vesicoureteral reflux, diverticula, neurogenic bladder - cystography;
- control of drainage and patency after operations (antegrade pyelography, fistulography).
Place of x-ray for diseases of the urinary system
Although MSCT has largely replaced classical urography, X-ray techniques remain indispensable where a functional and “dynamic” picture is needed with a lower dose: monitoring the passage of stones using a survey image, assessing the urethra during urination (voice cystourethrography is the only way to see reflux and the posterior urethra), checking drainages and anastomoses with contrast. The studies are performed by a urologist and a radiologist at the clinic in conjunction, so the images are immediately interpreted in the context of treatment.
