Abstract
Anterior urethral stricture is a common clinical condition encountered in day-to-day urological practice affecting predominantly males. Retrograde urethrography (RGU) is a common investigation done to determine the future course of management. But with increasing use of plastic surgery and other endoscopic procedures, information regarding presence of spongiofibrosis and other associated conditions, in addition to length of stricture is being demanded from radiologist for deciding the mode of management. Sonourethrography (SUG) has started gaining acceptance over RGU in last few decades for determining periurethral spongiofibrosis which at the same time obviates radiation to gonads. In recent years, magnetic resonance urethrography (MRU) has also been advocated for evaluation of anterior urethral strictures due to its excellent soft tissue contrast and lack of operator dependence. Besides, MRU can delineate posterior urethra simultaneously, affecting further management obviating the need for micturating cystourethrogram (MCU). Hence, in this article we evaluate the comparative role of SUG ad MRU in the evaluation of male anterior urethral strictures.
Highlights
Strictures or luminal narrowing of male urethra are broadly categorized in to anterior and posterior type depending upon© Copyright iMedPub | This article is available from: http://www.aclr.com.es/An experienced radiologist blinded to both Retrograde urethrography (RGU) and magnetic resonance urethrography (MRU) findings, recorded the SUG findings
Twenty male patients with first-time diagnosis of anterior urethral stricture on RGU were referred to our department for MRU that was performed on 1.5 Tesla MRI scanner following distension of the urethra by instillation of optimal amounts of sterile gel per urethram and application of soft-plastic, peniletip clamp
Data related to site and length of stricture; presence or absence of spongiofibrosis with its extent and any other associated abnormality was recorded in both SUG and MRU
Summary
An experienced radiologist blinded to both RGU and MRU findings, recorded the SUG findings. While the radiologist recorded MRU findings, he was blinded about the RGU and SUG findings of the patient. Out of 20 patients, three patients were excluded from our study due to suboptimal quality of MRI scan. The age of the patients ranged from 18 to 72 years with 10 patients having history of infection, 3 with history of trauma, 3 with history of previous urethral instrumentation and one with none of the above histories i.e. idiopathic. Long-segment stricture in anterior urethra was detected in 10 out of 17 (58.8%) patients by SUG while MRU detected it in 14 out of 17 (82.4%) patients meaning thereby that 4 patients were falsely-diagnosed as short-segment stricture by SUG out of which two were in bulbar and two in penobulbar urethra. SUG has a sensitivity, specificity, and accuracy of 71.4%, 42.9% and 76.5% respectively
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