PMC6159257_01
(a-d) A 23-year-old male with urethral duplication. Findings: RUG fluoroscopic coned-down spot images demonstrating (a) cannulation of the dorsal urethra meatus (black arrow) with minimal opacification of the dorsal urethra owing to resistance to Cystografin contrast flow (black arrow heads). (b) Continued gradual pressure resulted in dilatation of the atretic dorsal urethra terminating in a blind end without demonstration of communication with the ventral urethra or bladder (black arrow heads). A small volume of contrast spillage around the urethral meatus resulted owing to the significant resistance offered by the blind end (black arrow). (c) Cannulation of the ventral urethra with inflation of the Foley catheter balloon within the fossa navicularis (white arrow) and demonstration of a normal diameter ventral urethra (white arrows) relative to the atretic accessory urethra (black arrowheads). (d) Contrast is demonstrated tapering proximally at the level of the sphincteric mechanism within the ventral urethra (white arrow) despite increased injection pressure resulting in contrast spillage (white arrowheads). Persistent pressure resulted in further filling of the dorsal urethra demonstrating a tapered blind end without communication to the ventral urethra or bladder (black arrow). RUG, retrograde urethrogram.
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Since no urine, semen or other discharge had ever been noted to exude from the accessory urethra, a retrograde urethrogram (RUG) was performed (Figure 1).