Presentation
History of chronic urethritis.
Patient Data
Severe long segment irregular stricture is present at bulbar and membranus urethra. Prostatic urethra is not observed. Some of the contrast has intravasated into the corpora cavernosa. while some of it has entered draining veins.
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.