Editorial Comment

Abstract

The authors' findings in this very practical article are extremely interesting and somewhat concerning. They have conducted a retrospective review of their experience with the performance and interpretation of the retrograde urethrogram (RUG). Their initial hypothesis was that the interpretation by radiologists who read RUGs differs significantly from that of urologists. An RUG must possess 3 key components: the diagnosis of a stricture when present, the stricture's location within the urethra, and the stricture's length. On review of 397 patients over a 7-year period, the authors find that only 49% of the reports generated by a radiologist are adequate for interpretation. Furthermore, only 87% of those reports accurately identify a stricture compared with 96% when read by a urologist. In addition, comparing the interpreted stricture length on the x-ray with the actual measured stricture length in the operating room, they find that radiologists underestimate the total length of the stricture by 1.3 cm, whereas urologists underestimate them by 0.3 cm on average. Independently Interpreted Retrograde Urethrography Does Not Accurately Diagnose and Stage Anterior Urethral Stricture: The Importance of Urologist-performed UrethrographyUrologyVol. 83Issue 5PreviewTo compare the accuracy of retrograde urethrogram (RUG) interpretation between the primary physician performing the procedure and the independent physician interpreting the films to evaluate the suitability of relying on independent physician interpretations for the purposes of preoperative urethral stricture surgery planning. Full-Text PDF ReplyUrologyVol. 83Issue 5PreviewWe concur that a well-performed retrograde urethrogram forms the necessary “road map” when planning definitive treatment of a urethral stricture. Cystoscopy is diagnostic for a stricture but fails to accurately stage stricture location and length. Although other modalities such as uroflowmetry and ultrasound can further enhance staging, retrograde urethrography is still the essential tool for treatment planning.1 We strongly feel that urologists should perform and interpret their own urethrograms whenever possible. Full-Text PDF