What indicates the need for a retrograde urethrogram?

A retrograde urethrogram is a specific diagnostic procedure used to evaluate potential urethral injuries or abnormalities. The presence of blood at the meatus is particularly indicative of a possible injury to the urinary tract, especially in the context of trauma. Blood at the meatus raises suspicion for a urethral tear, and a retrograde urethrogram is essential to assess the urethra before any invasive procedures, such as catheter placement, are performed. This imaging technique helps visualize the urethra and determine the extent of any injury, guiding appropriate management.

In contrast, abdominal pain, fever, and vasospasm on physical examination do not directly point to urethral injury or the necessity for a retrograde urethrogram. These symptoms could be related to a variety of other underlying conditions but lack the specific indication provided by blood at the meatus, which warrants further investigation of the urethra specifically.