This document outlines the indications and contraindications for imaging urethra using augment imaging techniques, detailing conditions such as strictures and congenital abnormalities, while noting contraindications like acute urinary tract infections. It describes the imaging technique, including patient positioning and catheter insertion, along with specific anatomical features of the anterior and posterior urethra. Potential complications during the procedure, such as urethral trauma and contrast medium intravasation, are also mentioned.

1. AUG IMAGING
BY
DR.ANJANA AUGUSTINE

3. Indications
1. Stricture
2. Urethral trauma
3. Fistulae or false passage
4. Congenital abnormalities
Contraindications
1. Acute urinary tract infection
2. Recent instrumentation
Complications Due to the Technique
1. Acute urinary tract infection
2. Urethral trauma
3. Intravasation of contrast medium, especially if excessive pressure is
used to overcome a stricture

4. Contrast Medium
LOCM (urograffin).
Prewarming the contrast medium
will help reduce the incidence of spasm of the external sphincter.
Preliminary Image
supine posteroanterior (PA) of the bladder base and urethra.
Technique
1. Patient supine with slightly tilted legs.
2. Using aseptic technique, the tip of the catheter is inserted so that the balloon lies
in the fossa navicularis and its balloon is inflated with 2–3mL
3. Contrast medium is injected and steep (30–45°) oblique films are taken.
• Gentle traction on the catheter is used to straighten the penis over the
ipsilateral leg and prevent urethral overlap

5.  Anterior urethra:
• Penile (Spongy, Pendulous)
Urethra (~16 cm long): encased
by corpus spongiosum of the
penis
• the longest portion
• the fossa navicularis is a small
normal dilatation of the distal
penile urethra

6. •Bulbar (Bulbous) Urethra: traverses
the root of the penis
• it receives the ducts from
the bulbourethral glands and
the Littre’s glands
• The bulbo-membranous junction is
located at the inferior margin of the
urogenital diaphragm, and
corresponds to the “cone”- Located
at 1-1.5cm distal to inferior margin
of verumontanum.
• Connecting inferior margin of
obturator foramina intersecting
urethra.

7.  Posterior urethra-
• Membranous Urethra (1 cm long):
passes through the urogenital
diaphragm, surrounded by
sphincter urethrae
the shortest and narrowest portion
o Least distensible segment
• Prostatic Urethra (3 cm long):
surrounded by the prostate gland;
o The verumontanum -ovoid mound of
tissue on the posterior wall, housing
the utricle and ejaculatory duct
openings.
o it is seen as a triangular
structre on the posterior wall of
prostatic urethra

8. • Filling of cowper’s
gland/duct should not be
misinterpreted as
extravasation.

10. • Fistula extending from
bulbous urethra to perineum

11. • PENILE FRACTURE-Contrast
extravasation in penile
urethra

12. • Urethral diverticulum
• MC at peno scrotal
junction.

13. • Condyloma accuminata-
multiple small filling defects

14. • MALIGNANT TUMORS:
• MC location-bulbomembranous
urethra.
• SCC-Irregular narrowing of
bulbar urethra with multiple
sinus tracts.

15. references
• Chapman’s guide to radiological procedures.
• APA. Gray, H. (2013). Grays Anatomy. Arcturus
Publishing.

16. THANKYOU