MP15-12 URETHRAL STRICTURE (US) AND ARTIFICIAL URINARY SPHINCTER (AUS) REINSERTION RATES AFTER URETHRAL REPAIR AT THE TIME OF AUS EXPLANTATION FOR EROSION

Abstract

INTRODUCTION AND OBJECTIVES: Knowledge of urethral stricture anatomy is essential for appropriate surgical management. While retrograde urethrogram is considered the gold standard for evaluation, ultrasound urethrogram has been shown to be more accurate in determining anterior urethral stricture length and extent of spongiofibrosis. To date, ultrasound urethrograms have been primarily performed intra-operatively. We report the results of an outpatient ultrasound urethrogram technique, which eliminates the need for radiation exposure. METHODS: Twelve consecutive adult men presenting for anterior urethral reconstruction from 10/2013-10/2014 underwent outpatient ultrasound urethrogram. Patients were excluded from this study if any urethral imaging has been performed using radiation (retrograde urethrogram or voiding cystourethrogram). The Siemens Acuson S2000 Ultrasound System is used at our institution. Outpatient retrograde ultrasound urethrogram is performed with the patient in the frog-leg position. Lidocaine gel is injected through the meatus to distend the urethra and act as contrast. Linear High-frequency multi-hertz 18L6 and curved multi-hertz 6C2 probes are used to study the penile and bulbar urethra, respectively. Lengths of strictures as determined by outpatient ultrasound urethrogram and direct intra-operative measurements were analyzed by a paired t-test. RESULTS: Table 1 shows the differences between ultrasound urethrogram and intra-operative stricture lengths. The difference between ultrasound urethrogram stricture length measurement (mean1⁄41.7833, standard deviation1⁄40.8892) and intra-operative stricture length measurement (mean1⁄41.7500, standard deviation1⁄41.011) was not significant with t(11)1⁄40.358, p1⁄40.727. Further, the correlation coefficient between the two length measurements is 0.950 (p<0.001). CONCLUSIONS: Our technique of outpatient ultrasound urethrogram for the diagnosis and characterization of anterior urethral strictures is simple, accurate, and eliminates the need for radiation exposure for evaluation of anterior urethral strictures.