Retrograde pericatheter urethrography (RPU) technique and its clinical use after urethroplasty: A single center experience

Abstract

Objective: To describe our technique of retrograde pericatheter urethrography (RPU) and its clinical use after urethroplasty.

Subjects and methods: Between January 2008 and December 2013, 387 patients with urethral stricture underwent urethroplasty at our center. A total of 343 of these patients underwent RPU 3 weeks postoperatively. For this retrospective study their files were evaluated with regard to: demographics, duration of symptoms, site, mean length of stricture, type of surgery, RPU findings, contrast-medium related complications and need of re-intervention. The eventual surgical success was defined as asymptomatic voiding with no clinical evidence of residual stricture (good flow rate and no residual urine) until the last follow up.

Results: Follow up ranged from 8 to 41 (mean 28) months. The mean duration of symptoms was 4.8 months. The mean stricture length, as seen on radiography, was 2.1 cm. 183 patients (53.3%) underwent anastomotic urethroplasty, while 160 (46.6%) underwent substitution urethroplasty. RPU showed urethral healing in 292 (85.2%) and contrast extravasation in 51 (14.8%) patients. No contrast-medium related complications were reported. Re-intervention was needed in 7.2% (21/292) of the patients who showed normal urethral healing and in 74.5% (38/51) of the patients who showed contrast extravasation on RPU. By the time of the last follow up the overall success rate was 82.7% (284/343 patients).

Conclusion: RPU is the most useful radiological diagnostic method for evaluating the appropriate time for catheter removal after urethroplasty. It helps to assess urethral healing and patency after urethroplasty. Prolonged catheterization in patients showing contrast extravasation may be helpful.

Keywords: Catheter removal; Contrast; Retrograde pericatheter urethrogram; Urethral stricture; Urethroplasty