A 32-year-old male presented with a history of urinary retention and difficult catheterization. An antegrade urethrography revealed multiple strictures in the bulbous and membranous urethra as well as diverticulations in the bladder wall. He was diagnosed with gonococcal urethritis likely caused by Neisseria gonorrhoeae due to his history of multiple sexual partners. Complications of gonorrhea can include urethral strictures, prostatitis, and infertility.

1. CASE STUDY
DR. UMAR TAUQIR
PGR RADIOLOGY
ALNOOR DIAGNOSTICS

2. HISTORY
• A 32 Year old male presented to us with
h/o urinary retention 2 –weeks back with
difficult & painful catheterization
• Patient gave h/o multiple sexual partners.
• He was referred to us for Ante-grade
urethrography.
• O/E supra pubic catheter seen.

4. • Study demonstrates multiple strictures in
bulbous and membranous urethera.

5. Study demonstrates multiple strictures and
diverticulations in urinary bladder wall
possible a sequel of cystitis

6. Study demonstrates prominence of pelvicalyceal
system most likely represent a reflux of contrast.

7. DIAGNOSIS
•Gonococcal
urethritis

8. Etiology
• N gonorrhoeae is a gram-negative,
intracellular, aerobic diplococcus; more
specifically, it is a form of diplococcus
known as the gonococcus. N gonorrhoeae
is spread by sexual contact or through
vertical transmission during childbirth

9. RISK FACTORS
• Risk factors for gonorrhea include the following:
• Sexual exposure to an infected partner without barrier protection
(eg, failure to use a condom or condom failure) [13]
• Multiple sex partners
• Male homosexuality
• Low socioeconomic status
• Minority status - Blacks, Hispanics, and Native Americans have the
highest rates in the United States
• History of concurrent or past STDs
• Exchange of sex for drugs or money
• Use of crack cocaine
• Early age of onset of sexual activity
• Pelvic inflammatory disease (PID) - Use of an intrauterine device
(IUD)

10. COMPLICATIONS
• Urethral strictures
• Urethritis
• Prostatitis
• Penile lymphangitis
• Para urethral abscess
• Tubal scaring
• Infertility in females & males both
• PID
• Epididymitis
• Orchitis

12. PROSTATIC URETHRA
• The prostatic urethra is the portion of the
urethra that traverses the prostate. It
originates in the region of the bladder
neck, courses roughly 2.5 cm inferiorly,
and terminates at the membranous urethra

13. MEMBRANOUS URETHRA
• he intermediate part of male urethra
(membranous portion) is the shortest,
least dilatable, and, the narrowest part of
the canal. The membranous portion of the
urethra is completely surrounded by the
fibers of the Sphincter urethrae membrane

14. SPONGY URETHRA
• The spongy urethra is the region that
spans the corpus spongiosum of the
penis. It is divided into the pendulous
urethra and the bulbous (or bulbar)
urethra. The pendulous urethra is invested
in the corpus spongiosum of the penis in
the pendulous portion of the penis. The
urethra is located concentrically within the
corpus spongiosum.

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