Letter to the editor re: Retrograde urethrography, sonouretrography and magnetic resonance urethrography in evaluation of male urethral strictures: should the novel methods become the new standard in radiological diagnosis of urethral stricture disease? Mikolaj et al., IJUN (October 2021)

2022 ◽  
Author(s):  
Daniel P. McNicholas ◽  
Ahmad M. Omar ◽  
Rauf N. Khadr ◽  
Michael S. Floyd
Keyword(s):  
Magnetic Resonance ◽  
Urethral Stricture ◽  
Radiological Diagnosis ◽  
The Novel ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
Letter To The Editor ◽  
Retrograde Urethrography ◽  
Novel Methods

MAGNETIC RESONANCE URETHROGRAPHY VERSUS RETROGRADE URETHROGRAPHY IN THE EVALUATION OF ANTERIOR URETHRAL STRICTURE DISEASE: A PROSPECTIVE STUDY

2008 ◽  
Vol 179 (4S) ◽  
pp. 682-683
Author(s):  
Mohammed Elgammal ◽  
Ayman Mahdy ◽  
Hisham Imam ◽  
Hisham Hammouda ◽  
Ahmed Abdel-Moneim ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Prospective Study ◽  
Urethral Stricture ◽  
Urethral Stricture Disease ◽  
Retrograde Urethrography ◽  
A Prospective Study

scholarly journals Retrograde urethrography, sonouretrography and magnetic resonance urethrography in evaluation of male urethral strictures. Should the novel methods become the new standard in radiological diagnosis of urethral stricture disease?

2021 ◽  
Author(s):  
Frankiewicz Mikolaj ◽  
Markiet Karolina ◽  
Kozak Oliwia ◽  
Krukowski Jakub ◽  
Kałużny Adam ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Urethral Stricture ◽  
Imaging Techniques ◽  
Accurate Method ◽  
Perfect Agreement ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
Additional Imaging ◽  
Male Patients ◽  
Diagnostic Modalities

Abstract Purpose To verify which of the diagnostic modalities: Voiding cystouretrography (VCUG), Sonouretrography (SUG) or Magnetic resonance uretrography (MRU) is the most accurate in the assessment of urethral strictures in males and in what cases the application of novel imaging techniques benefits most. Methods 55 male patients with a diagnosis of urethral stricture, were enrolled in this prospective study. Initial diagnosis of urethral stricture was based on anamnesis, uroflowmetry and VCUG. Additional imaging procedures—SUG and MRU were performed before the surgery. Virtual models and 3D printed models of the urethra with the stricture were created based on the MRU data. Exact stricture length and location were evaluated by each radiological method and accuracy was verified intraoperatively. Agreement between SUG and MRU assessments of spongiofibrosis was evaluated. MRU images were independently interpreted by two radiologists (MRU 1, MRU 2) and rater reliability was calculated. Results MRU was the most accurate [(95% CI 0.786–0.882), p < 0.0005] with an average overestimation of 1.145 mm (MRU 1) and 0.727 mm (MRU 2) as compared with the operative measure. VCUG was less accurate [(95% CI 0.536–0.769), p < 0.0005] with an average underestimation of 1.509 mm as compared with operative measure. SUG was the least accurate method [(95% CI 0.510–0.776), p < 0.0005] with an average overestimation of 2.127 mm as compared with the operative measure. There was almost perfect agreement of MRU interpretations between the radiologists. Conclusions VCUG is still considered as a ‘gold standard’ in diagnosing urethral stricture disease despite its limitations. SUG and MRU provide extra guidance in preoperative planning and should be considered as supplemental for diagnosing urethral stricture. Combination of VCUG and SUG may be an optimal set of radiological tools for diagnosing patients with urethral strictures located in the penile urethra. MRU is the most accurate method and should particularly be considered in cases of post-traumatic or multiple strictures and strictures located in the posterior urethra.

Urethral strictures

2017 ◽  
Author(s):  
Anthony R. Mundy ◽  
Daniela E. Andrich
Keyword(s):  
Urethral Stricture ◽  
Daily Basis ◽  
Current Approach ◽  
Curative Treatment ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
History Of ◽  
The Subject ◽  
Ambivalent Attitude ◽  
Almost All

Urethral strictures are common and almost all urologists will deal with them on a regular if not daily basis. They have always been common and the history of the subject stretches back to 3,000 BC. Urethral dilators have been found in the tombs of the pharaohs so that they might be able to catheterize themselves or dilate their own strictures in the afterlife. Urethrotomy and dilatation are two of the most frequently performed procedures in urology. But these are usually only palliative, and curative treatment by urethroplasty is performed by very few urologists. In part this is because most strictures are bulbar strictures and most non-bulbar strictures are seen only by reconstructive urologists; but in part this represents a somewhat ambivalent attitude of most urologists to urethral stricture disease. In this chapter, we will attempt to clarify the current approach to this problem.

scholarly journals Retrograde urethrosonography with SonoVue in strictures of the male urethra: a pilot study

2020 ◽  
Vol 22 (4) ◽  
pp. 424
Author(s):  
Mihai Domnutiu Suciu ◽  
Nucu Alexandru Marica ◽  
Alexandru Florin Badea ◽  
Iulia Laura Gavrila ◽  
Radu Ion Badea
Keyword(s):  
Pilot Study ◽  
Comparative Study ◽  
Real Time ◽  
Urethral Stricture ◽  
Adult Male ◽  
Radiological Examination ◽  
Male Urethra ◽  
Urethral Strictures ◽  
Retrograde Urethrography ◽  
Contrast Enhanced

Aim: To evaluate the effectiveness of SonoVue urethrosonography in diagnosing the adult male anterior urethral strictures pathology in comparison with retrograde urethrography.Material and method: We standardised the method and performed a comparative study evaluating the diagnosis of urethral strictures using retrograde urethrography and retrograde ultrasonographic exploration with SonoVue on 6 male patients.Results: In all patients, the existence of urethral stricture, localization and its extension were confirmed. Contrast-enhanced ultrasonographic exploration brought additional categories of information: the degree of spongiofibrosis, the elasticity of the urethral walls and the presence of urethral lithiasis. There were no periprocedural incidents.Conclusion: This pilot study demonstrates the feasibility and innocuity of urethral ultrasound with SonoVue. Real-time ultrasound exploration highlights aspects that are not seen in radiological examination, so the method can be complementary or alternative to this procedure. 

scholarly journals Clinical features of spongy urethral strictures requiring multi-stage urethroplasty or permanent urethrostomy

2021 ◽  
Vol 14 (3) ◽  
pp. 156-163
Author(s):  
V.P. Glukhov ◽  
◽  
A.V. Ilyash ◽  
V.V. Mitusov ◽  
D.V. Sizyakin ◽  
...  
Keyword(s):  
Clinical Features ◽  
Urethral Stricture ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Urethral Stricture Disease ◽  
One Stage ◽  
Urethral Strictures ◽  
Multi Stage ◽  
History Of ◽  
Urethral Surgery

Introduction. Extended spongy urethral strictures require the use of plastic surgery techniques. In most cases, a one-stage urethral repair can be performed. However, staged urethroplasty and permanent urethrostomy are important in patients with extremely complex urethral strictures. Purpose of the study. To determine the clinical features of spongy urethral strictures, which cannot be cured by one-stage urethroplasty, but are subject to multistage plastic or permanent urethrostomy. Materials and methods. The study included 158 patients who underwent surgery for urethral strictures in 2010 − 2019. Inclusion criteria: spongy urethral strictures requiring staged urethroplasty or permanent urethrostomy. Exclusion criteria: age<18 years, proximal urethral strictures, urethra-vesical anastomosis and bladder neck stenosis, previously untreated congenital anomalies (hypospadias and epispadias), and history of any other urethral surgery not meeting the inclusion criteria. Results. The age of the patients ranged from 18 to 88 years. Iatrogenic (34.8%) and inflammatory (32.3%) urethral lesions predominate in the structure of etiological factors with the most common penile localization of narrowing (43.7%). The length of strictures in half of the patients exceeds 6 cm; a quarter of the sample has subtotal and total spongy urethral lesions. The proportion of recurrent urethral strictures is 56.3%. The average duration of the urethral stricture disease reaches 8 years. In 61.3% of cases, the disease is accompanied by complications from both local tissues and organs of the urinary and reproductive systems. Conclusion. Clinical evaluation of patients with spongy urethral strictures requiring multi-stage urethroplasty or permanent urethrostomy reveals a particular severity of urethral stricture disease. This category of patients has a high risk of unsuccessful outcomes with one-stage surgery. In these cases, patients require a multi-staged urethroplasty or a permanent urethrostomy.

Penile urethral stricture disease

2018 ◽  
Vol 12 (2) ◽  
pp. 145-157
Author(s):  
Marco Spilotros ◽  
Suzie Venn ◽  
Paul Anderson ◽  
Tamsin Greenwell
Keyword(s):  
Urethral Stricture ◽  
Lichen Sclerosus ◽  
Corpus Spongiosum ◽  
Hypospadias Repair ◽  
Internal Urethrotomy ◽  
Level Of Evidence ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
Considerable Cost ◽  
The Uk

Patients affected by a urethral stricture account for a considerable cost to all healthcare systems. The estimated prevalence of all urethral stricture in the UK is 10/100,000 men during youth, increasing to about 40/100,000 by age 65 years and to more than 100/100,000 thereafter. A penile urethral stricture is a narrowing of the lumen of the urethra due to ischaemic fibrosis of the urethral epithelium and/or spongiofibrosis of the corpus spongiosum occurring within the penile urethra. Its aetiology is largely idiopathic but other important causes are failed hypospadias repair and lichen sclerosus, which account for 60% of all cases. Strictures of the anterior urethra account for 92% of cases: bulbar strictures are more frequent (46.9%), followed by penile (30.5%) and combined bulbar/penile (9.9%), that is, 40.4% of all men presenting with stricture will have a penile urethral stricture alone or in combination with a bulbar urethral stricture. There are several options for the treatment of penile urethral strictures ranging from less invasive treatments, including urethral dilatation and direct vision internal urethrotomy, to more complex augmentation graft and flap urethroplasty. The aim of the present review is to describe the aetiology and epidemiology of anterior urethral strictures and the available options reported in literature for their treatment. Level of evidence: 1a

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