Choke voiding cystourethography

Case contributed by Matt A. Morgan

Presentation

Patient underwent a radical retropubic prostatectomy five years earlier. He also had postoperative radiation therapy and a history of bladder neck contracture with dilation incision. Currently wears a Texas catheter for post-prostatectomy incontinence.

Patient Data

Age: 60 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Fluoroscopy

The patient was filled in a retrograde manner, but because of his severe incontinence, very little contrast remained in the bladder.

A penile clamp (radiolucent clamp between the radiopaque markers) was applied at the meatus to create enough pressure in the bladder and urethra to allow a decent voiding cystourethrogram.

Annotated image

A red box outlines the mostly radiolucent penile clamp. Pressure on the underlying urethra is evident.

Case Discussion

A penile clamp can be judiciously applied when a VCUG needs to be performed, but the patient has severe incontinence. Another term for this procedure is choke voiding cystourethrography. One could use one's hand to apply pressure to the meatus, but the clamp keeps the radiologist's hand out of x-ray beam.

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