Affiliations: Department of Urology, Shanghai Sixth People's
Hospital, Shanghai Jiaotong University, Shanghai Oriental Institute for
Urologic Reconstruction, Shanghai, China | Wake Forest Institute for Regenerative Medicine, Wake
Forest University School of Medicine, Winston Salem, NC, USA
Abstract: Urethral injures, pelvic trauma, and certain congential
abnormalities in male can often cause urethral strictures and scarring.
Adequate and accurate imaging diagnosis of urethral strictures is critial to
select a surgical approach. Although urethrography is commonly used in
evaluating male urethral injury and strictures, its limitation is that the
contrast offers images only at the urethral lumen but not of the periurethral
structures. Sonourethrography (SUG) has the ability to define the periurethral
tissues and without the radiation exposure, the degree of periurethral fibrosis
can be shown with a view to guiding surgery especially in bulbar urethra.
Computed tomography (CT) urethrography has the advantage of examining patients
only in one position, and by generating three-dimensional images; it can
accurately measure the stricture length. Magnetic resonance imaging (MRI)
provide useful information in certain clinical situations, particularly
posterior urethral trauma and in the evaluation of the periurethral soft
tissues. However, both CT and MRI are relative high cost. The selection of
imaging methods should depend on the etiology, sites, patient's general
condition and the type of urethral injury, using a rational combination of
different imaging methods can improve the accuracy of diagnosis for traumatic
urethral strictures.
