Radiographic Positioning: Radiographic Positioning of a Retrograde Urethrogram

RETROGRADE URETHROGRAM (DOUBLE BALLOON)

This procedure is done on female patients to check for urethral diverticula. A scout film (KUB) must be taken to include the area just below the pubic symphisis.

Items needed for study:
Urethral cath tray
1 catheter tip syringe
1 60 cc Luer LOC syringe
2 bottles of Conray 43
50 cc's sterile saline (to dilute 1 of the bottles of Conray 43)
19 gauge Angio cath
double balloon catheter

The catheter has two balloons, the upper balloon is fixed and the lower balloon is a sliding balloon. Before placing the catheter in the urethra, put a very small amount of water soluble lubricant near the lower sliding balloon and slide it down to approximately the middle of the catheter. Place as small amount of water soluble lubricant needed on the end of the catheter for insertion (too much could possibly "clog" the side holes of the catheter or "fill in" the diverticula). After the catheter is placed into the bladder, fill the upper balloon with 30 cc's of 50% Conray - 50% saline mixture. After that is completed, slide the lower uninflated balloon up (while pulling down on the catheter to pull the upper balloon against the bladder) until the lower balloon is against the outside of the urethra. Using the "soft" part of the Angio cath, inflate the lower balloon with 30 cc's of the diluted Conray mixture. Insert the cath tip syringe into the end of the catheter. It is not unusual that the contrast will go up into the bladder. If this happens, the catheter will need to be pulled down tighter against the bladder. If the contrast leaks out distally, the lower balloon will need to be slid up even more.

***DO NOT USE AIR TO INFLATE THE BALLOONS***