What findings would prompt a healthcare provider to perform a retrograde urethrogram?

A retrograde urethrogram is a specific imaging study used to evaluate the anatomy of the urethra and any potential injuries or abnormalities. When there is blood at the urethral meatus, it raises significant concern for a possible urethral injury or trauma. In the context of acute injury, this finding prompts healthcare providers to perform further diagnostic work to ascertain the integrity of the urethra before attempting any catheterization that could exacerbate an injury.

In cases of blood at the urethral meatus, the use of a retrograde urethrogram helps visualize and assess the urethra for lacerations or strictures, guiding the clinician in managing the patient's treatment appropriately. Because this condition directly indicates a potential traumatic injury, it is considered a definitive reason to pursue a retrograde urethrogram.

Pain with urination, visible hematuria, and flank pain, while indicative of different urologic issues, do not specifically warrant a retrograde urethrogram as a first-line investigative approach. These symptoms may suggest conditions such as urinary tract infections, kidney stones, or bladder-related issues, where other diagnostic tools like urinalysis or imaging studies may be more appropriate initially.