DIAGNOSIS OF TRAUMATIC URETHRAL STRICTURES

Abstract

Abstract

Introduction: Although radiographic retrograde uretrography has traditionally been the gold standard for

imaging the urethra, sonourethrography and MR urethrography have proved to be precise and effective for

evaluating urethral stricture.

Materials and Methods: Except for radiologic methods, urethroscopy and cysto-urethroscopy by

cystostomy tract are, at the same time, most effective diagnostic methods that are used in evaluation of

urethral strictures.

Retrograde urethrography is performed by injecting a contrast into the external meatus and obtaining

radiographs in oblique projection to visualize whole urethra. If properly performed contrast medium can be

seen jetting through the Bladder neck into the bladder. Voiding urethrography is usually performed after the

bladder is filled via a transurethral or suprapubic catheter. After the transurethral catheter is withdrawn the

patient voids under roentgen and spot radiographs of the bladder and urethra are obtained.

Ultrasonography of the anterior urethra offers a dynamic three-dimensional study that can be easily

repeated without ionizing radiation to the gonads. During the examination, the entire anterior urethra is

distended by constant, slow injection of saline via in an irrigation syringe. And it can be selected as static or

dynamic images for documentation.

The anatomic details of both the urethra and periurethral tissues can be evaluated noninvasively with

magnetic resonance (MR) imaging; this modality can be used as an adjunctive modality tool for evaluation of

urethral strictures.

Urethroscopy and cysto-urethroscopy by cystostomy tract are very important methods which determine

number, localization and length of strictures. If they are performed simultaneously by adding rectal

examination, it will give us information about stricture length. It is helpful how kind operation will be planed.

We review the methods retrograde urethrogrphy, voiding urethrography, sonourethrograpy and MR

urethrography for evaluation of post traumatic urethral stricture.

Results: Sonourethrography measures stricture length in the anterior urethra as well as conventional

urethrography and it is useful for evaluating corpus cavernosum and corpus spongiosum. MR imaging is also

useful for defining short strictures and better visualization of periurethral tissue and pelvic anatomy.

Urethroscopy and cystoscopy from cystostomy tract is very important diagnostic methods in evaluation of

urethral stricture disease.

Conclusion: Sonourethrography is useful for imaging anterior urethra as well as conventional

urethrography. This technique can be more useful combining with conventional urethrography. MR

urethrography is a new method for defining urethral strictures. But also has advantages imaging for pelvic

anatomy and periurethral tissues.

Urethroscopy and cystoscopy from cystostomy tract must be done before operation in order to evaluate

the stricture and to plan kind of operation.