A Comparative Study of Sonourethrography and Retrograde Urethrography in Evaluation of Anterior Male Urethral Strictures

Introduction: The male urethral imaging and pathology is not widespread in the radiology literature because this part of the urinary tract is easily studied by urologists. However urethral obstructive pathologies especially stricture disease is a gray area which needs thorough imaging. Retrograde urethrography has been the standard imaging technique for the evaluation of male anterior urethra, which involves use of radiation and contrast medium. Sonourethrography is a new technique for imaging the male anterior urethra with high-resolution ultrasound while intra-urethral instillation of normal saline. Aims & Objectives: This study was undertaken to explore the uses of sonourethrography with high-resolution ultrasound in evaluating stricture disease of the male anterior urethra and comparing it with retrograde urethrography. Materials & Methods: This study was carried out on 60 male patients referred for retrograde urethrography to the department of Radiodiagnosis. These patients underwent retrograde urethrography followed by sonourethrography. Result: Out of 60 patients, 11 patients were normal, 44 patients had stricture. Rest 5 patients without stricture had Urethrocutaneus fi stula, false tract and diverticula. Total 53 strictures were demonstrated in 44 patients, 51 were diagnosed on sonourethrography and 53 on retrograde urethrography. One bulbar and two membranous urethra strictures were missed on sonourethrography and diagnosed on retrograde urethrography. One penile stricture was diagnosed on sonourethrography but missed on retrograde urethrography. Strictures were further characterized as per location, number, length, periurethral fi brosis and other fi ndings. Conclusion: Compared with retrograde urethrography, sonourethrography is equally effi cacious in detecting anterior urethral strictures. The further characterization of strictures in terms of length, periurethral pathologies can be performed with relatively greater sensitivity using the sonourethrography. Thus, ability of sonourethrography to diagnose periurethral pathologies and length of stricture helps in planning proper surgical procedure.