Rug Blood Meatus
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If the rug shows a partial urethral injury a single attempt at urethral catheterization can be tried by someone experienced.
Rug blood meatus. Place a catheter 8 french into the urethral orifice gently inject 15 20 ml of contrast medium and obtain an oblique plain film of pelvis. Fracture of the penis. Retrograde urethrography rug scan in a patient with blood at the meatus and inability to void at presentation. The standard imaging method used to diagnose urethral trauma is rug.
This procedure may also be done under fluoroscopic guidance. Rug in a patient with a history of urethral bleed and a normal physical examination. Blood in the meatus is a strong indication for imaging and rug should be performed prior to any therapeutic attempt. 5 10 while various techniques have been described to implement rug the most common utilizes a foley catheter 12 20 with this method the patient is ideally positioned for imaging in an approximate 45 oblique angle with the penis stretched so that the meatus points cephalad.
A partial injury is generally treated with endoscopic or. 8 9 lower urinary tract structural pathologies that warrant rug include abnormalities such as urethral strictures urethral diverticulum or urethral. Grade b or c. Rug should be performed for patients with blood at the meatus who cannot void or with straddle injuries.
Penile fracture with gross hematuria is also an indication for a rug to elucidate the presence of a urethral injury. The most common indication for a rug in the setting of trauma is the presence of blood at the urethral meatus after blunt or penetrating trauma. A case series and literature review. The differentiation between a partial or complete tear is crucial for patient management.
Penetrating anterior urethral injury immediate surgical repair. The aua urotrauma guideline recommends to always to do a retrograde urethrogram rug when there is blood at the urethral meatus. Blood at the tip of the meatus a high riding bladder or prostate on abdominal and rectal examination or a suspected pelvic fracture should all merit a retrograde urethrogram rug before catheter placement to avoid converting a partial urethral disruption into a complete one. Retrograde urethrogram rug with voiding cystourethrogram vcug.
Partial tears can be managed conservatively while complete urethral ruptures demand a surgical treatment. Grade b or c. Necessary in patients with blood at the urethral meatus a high riding prostate or if catheterization is difficult. Men are then asked to void vcug and again x rays are taken to better outline the level of stricture.
X ray constrast dye is used to fill the urethra and bladder as images are obtained identifying the level of blockage.
Pdf Imaging Of Urethral Disease A Pictorial Review1
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