IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Urethral stricture with prior hypospadias repair

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Weak urinary stream and difficulty in urination. Past history of surgery for hypospadias in the childhood.

Patient Data

Age: 45 years
Gender: Male

Retrograde urethrogram (RUG)

Fluoroscopy

A long smooth stricture measuring approximately 6 cm in length is noted in the distal penile urethra. This stricture is associated with mild diffuse dilatation of the remaining anterior urethra. Small amount of contrast passage is noted through the posterior urethra into the urinary bladder. No contrast leakage/extravasation is noted.

N.B. Procedure was done with a 5 French feeding tube after failure of insertion of 8 French Foley's catheter.

Case Discussion

  • In view of the history, this urethral stricture is related to the prior hypospadias repair.

  • The most common complication of hypospadias surgery is stricture formation at the site of anastomosis which can occur months to years after the surgery 1. Retrograde urethrogram (RUG) is usually performed by injecting the contrast into the distal urethra via a Foley’s catheter, which is held in by placing its inflated balloon in the fossa navicularis. However, in the patients with hypospadias (either preoperatively or postoperatively), RUG is performed with a feeding tube instead of a Foley’s catheter due to the absence of a normal fossa navicularis 1.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.