Sonourethrogram in comparison with retrograde urethrogram in evaluation of male anterior urethra
Abstract
Objective: Imaging of anterior male urethra is usually done using retrograde urethrogram, which utilises radiation. This study utilises high resolution ultrasound which is radiation free and helps to understand urethral pathologies like strictures, chronic urethritis etc. This study also compares the utility of sonourethrogram with retrograde urethrogram and provides the advantages of using sonourethrogram. Also establishes the drawbacks of using sonourethrogram over retrograde urethrogram.
Material & Methods: This study was done on 60 patients, came with different complaints like difficulty in micturition, obstructed urinary stream, pain in penis, increasing frequency of micturition and referred to us for retrograde urethrogram. Patients were examined with high resolution ultrasound with due permissions. Results are compared with findings of retrograde urerthrogram.
Results: Out of 60 patients, 59 had strictures shown in retrograde urethrogram either in penile, bulbar or membranous parts. Only one patient had membranous urethral stricture in retrograde urethrogram which was not shown in sonourethrogram. All other patients have shown strictures in sonourethrogram. One patient had penile urethral calculus shown in both sonourethrogram and retrograde urethrogram.
Conclusion: Sonourethrogram is equally effective as that of retrograde urethrogram especially in anterior urethral strictures. However, it underestimates or less useful in evaluation of posterior male urethral pathologies. Sonourethrogram is easily available, cost effective technique that uses no radiation in the evaluation of male urethra. It is equally effective compared to retrograde urethrogram in the evaluation of male anterior urethral strictures. Periurethral pathologies like fibrosis are better evaluated with sonourethrogram than with retrograde urethrogram. It is also important in the surgical planning and approach.
Downloads
References
Shaida N, Berman LH. Ultrasound of the male anterior urethra. Br J Radiol. 2012;85(1):S94-S101. doi: https://doi.org/10.1259/bjr/62473200. Epub 2012 Jun 6.
Hatgaonkar A. A Comparative Study of Sonourethrography and Retrograde Urethrography in Evaluation of Anterior Male Urethral Strictures. Int J Sci Study. 2014;2(2):5-12.
McAninch JW, Laing FC, Jeffrey RB Jr. Sonourethrography in the evaluation of urethral strictures: a preliminary report. J Urol. 1988;139 (2): 294-297. doi: https://doi.org/10.1016/S0022-5347(17)42391-3
Hampson LA, Jack W. McAninch JW, Breyer BN. Male urethral strictures and their management.” Nature reviews. Urol. 2014;11(1):43-50. doi: https://doi.org/10.1038/nrurol.2013.275
Merkle W, Wagner W. Sonography of the distal male urethra--a new diagnostic procedure for urethral strictures: results of a retrospective study. J Urol. 1988; 140(6):1409-1411.doi: https://doi.org/10.1016/S0022-5347(17)42057-X
Jordan GH, Schlossberg SM, Devine CJ. Surgery of the penis and urethra. In: F.C. Walsh, A.B. Retik, E.D. Vaughan, Jr et al.Campbell’s urology (7th ed.), WB Saunders, Philadelphia. 1998; 3318-3394.
Pavlica P, Barozzi L, Menchi I. Imaging of male urethra. Eur Radiol. 2003;13(7):1583-1596. Epub 2002 Dec 19. doi: https://doi.org/10.1007/s00330-002-1758-7
Gong EM, Arellano CM, Chow JS, Lee RS. Sonourethrogram to manage adolescent anterior urethral stricture. J Urol. 2010;184(4):1699-1702. doi: https://doi.org/10.1016/j.juro.2010.03.074. Epub 2010 Aug 21.
Mitterberger M, Christian G, Pinggera GM, Bartsch G, Strasser H, Pallwein L. Gray scale and color Doppler sonography with extended field of view technique for the diagnostic evaluation of anterior urethral strictures. J Urol. 2007;177(3):992-996. doi: https://doi.org/10.1016/j.juro.2006.10.026
Gupta L, Sharma S, Gupta DK. Is there a need to do routine sonological, urodynamic study and cystourethroscopic evaluation of patients with simple hypospadias? Pediat Surg Int. 2010;26(10):971-976. doi: https://doi.org/10.1007/s00383-010-2652-z.
Ferguson GG, Bullock TL, Anderson RE, Blalock RE, Brandes SB. Minimally invasive methods for bulbar urethral strictures: a survey of members of the American Urological Association. Urology. 2011;78 (3): 701-706. doi: https://doi.org/10.1016/j.urology.2011.02.051. Epub 2011 Jul 18.
OAI - Open Archives Initiative
