Urethrography in the male: the clamp method.

Background: Retrograde urethrography is considered the gold standard for evaluating stenosis or urethral disease.
Purpose: To describe the clamp method for optimizing retrograde urethrography (RUG) using a perfected device and a drip infusion system. material and methods: RUG was performed in 42 patients with a mean age of 63.4+/-16.5 years suspected of having urethral stenosis. The modifications to the device are shown, and the steps of the technique described. The intensity of pain from both catheterization and external compression was measured on a visual analog scale (VAS).
Results: All the RUG examinations were conducted satisfactorily. The use of the drip infusion system enabled visualization of the posterior urethra in 97.6% of cases, and bladder repletion was achieved in 95.2% of cases. The urethrograms revealed images of stenosis in 31 patients. With catheterization the mean pain intensity registered by VAS was 0.7+/-0.6 (SD), whereas with external compression the mean pain intensity was 0.06+/-0.02 (SD).
Conclusion: The clamp method and drip infusion system used in this study are efficient and reduce patient discomfort. The procedure makes it possible to assess cases with stenosis close to the meatus that are difficult to manage with the conventional method.