Retrograde urethrography in children: a decade of experience at a children's hospital

Graph 1 shows frequency of retrograde urethrography (RUG, median: 17/year), contrast-enhanced voiding cystourethrography (ceVUS, median: 70/year), cystourethroscopy (median: 104/year), and voiding cystourethrography (VCUG, median: 511/year) over a ten year period (with 2020 excluded due to COVID-19).

Graph 2 shows average catheter size for children of various age groups.

• “Technical difficulties were reported in 14 children (8%): inadequate catheter seal with suboptimal urethral distention (9) and significant pain (5).”

• “In 100 children… cystourethroscopy/VCUG were performed in conjunction with RUG and were used as gold standard references. Cystourethroscopy/VCUG showed pathology in 34 children and was normal in 66 children.”

• “Some radiologists might rely solely on VCUG for evaluating all urethral, bladder, and reflux abnormalities without performing RUG… Radiologists should be aware that VCUG alone might not accurately demonstrate certain abnormalities of the male anterior urethra because the urethra is not fully distended to the degree seen on RUG.”