Imaging of the urethra: current status

Abstract

The male urethra is more prone to disease than the female urethra, notably trauma and stricture formation. These entities are traditionally investigated with retrograde and antegrade contrast studies, and more recently, with high frequency ultrasound. Diseases in the female, including urethral diverticula and sub-mucosal urethral cysts, are centred on the periurethral tissues rather than the lumen, and as such are better investigated by MRI. MRI is also central in the diagnosis and management of rare conditions of the urethra such as urethral fistulae and malignancy. This review considers all these imaging modalities, comparing their relative merits and summarizing optimal technique. Throughout, the imaging is related to the clinical conditions of: urethral strictures, urethral diverticula, trauma, urethral fistulae, calculous disease, malignancy and pelvic surgery.