Indian Journal of Surgery Medknow Publications on behalf of Association of Surgeons of India ISSN: 0972-2068 Vol. 68, Num. 3, 2006, pp. 169-169

Indian Journal of Surgery, Vol. 68, No. 3, May-June, 2006, pp. 169

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Intravasation of contrast during ascending urethrography

Sodhi KuljinderJ, Dave Divyang, Garg ChaitanyaP, Patel MukeshP

Department of Surgery, Government Medical College, New Civil Hospital, Surat
Correspondence Address:Kuljinder J. Sodhi, H. No. 1975, Sector 17, HUDA Colony, Yamunanagar - 135 001, Haryana, India. E-mail: crowfeet@sify.com

Code Number: is06048

A 45-year-old man presented with acute retention of urine without any past history of retention or catheterization. Per urethral catheterization was attempted, which failed and eventually a suprapubic cystostomy was done. Ultrasound and plain X-ray were normal.

Ascending urethrography was done after 3 weeks with due precautions, which revealed a stricture at the level of bulbar urethra. There was intravasation of contrast into the penile veins up to the draining vascular tree in the pelvis [Figure - 1].

Patient fortunately did not have any complications. Internal urethrotomy was done successfully and the patient was discharged after all tubes were out. The patient is fine till date, on regular follow-up and dilatations.

Intravasation of contrast is a known complication of ascending urethrography.[1] Only a few cases have been reported till date.[2] The mechanism of such intravasation is through the submucosal venous plexus of urethra when its mucosa is breached. This happens because of the fact that urethral mucosa is friable in inflammatory strictures and easily tears during attempts at catheterization or even during forceful injection of contrast during ascending urethrography [Figure - 2].[1]

The importance of this article is the fact that this intravasation of contrast dye, though rare, can be one of the fatal complications that can, in some patients, lead to anaphylactic shock, renal failure and even death.

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