Venous intravasation in retrograde urethrography

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Old trauma.

Patient Data

Age: 35 years
Gender: Male

Retrograde urethrogram reveals a possible mild stricture involving the bulbar urethra, with urethro-venous intravasation. 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 be 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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