Extravasation of contrast beneath the preputial skin due to improper technique of retrograde urethrogram

Description 

A 22-year-old uncircumcised male patient had a thin stream of urine and had to exert pressure while voiding. He had a history of some instrumentation in his penis during childhood, but no records were available. He was first seen by a primary care physician, who made a provisional diagnosis of stricture urethra and advised for a retrograde urethrogram (RUG). His RUG had a contrast shadow, which was thought to be possible dilated distal urethra due to proximal obstruction (stricture), and the patient was referred to us for further management (figure 1). When we examined the patient, he was found to have phimosis. A dorsal slit was done and the meatus was examined, which was normal. A gentle calibration was done with a 14F Foley catheter that was normal. He voided with a good stream after surgery. The radio-opaque shadow that was seen on the RUG...

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