Sonourethrography in the evaluation of anterior urethral stricture

The management of urethral stricture is a challenge to both the urologists and the patients. Thoughtful and satisfactory preoperative evaluation remains important to achieving good outcome. Retrograde urethrography and Micturating Cystourethrography (RUG/MCUG) have been the gold standard imaging technique in the evaluation of anterior urethral stricture but are not without inherent limitations and side effects. Sonourethrography (SUG) could diagnose anterior urethral stricture, measure its length, and detect presence of complications and extent of spongiofibrosis.

To establish the sensitivity of sonourethrography in the identification of the anterior urethral stricture. To determine the accuracy of sonourethrography in measuring the length of anterior urethral stricture as well as to detecting spongiofibrosis.

This was a prospective study of 60 patients clinically diagnosed to have anterior urethral stricture. The patients included in the study underwent both SUG and RUG/MCUG. The sensitivity of SUG was then calculated. Paired t-test was used to determine its ability to measure the length of the anterior urethral stricture. The percentage of patients detected to have spongiofibrosis on SUG was also computed.

The mean age of patients recruited for the study was 46 ± 18 years (Range = 9-69). The sensitivity of SUG was 94%. The lengths of anterior urethral stricture were 14.1 ± 1.9mm and 16.0 ± 2.1mm for RUG/MCUG and SUG respectively. The mean difference is 2.0mm (Confidence interval, CI = 0.872 - 2.911, p<0.05). SUG correctly identified spongiofibrosis in 31(51.7%) patients that had anterior urethral stricture.

This study has demonstrated that sonourethrography is a valuable diagnostic tool in the evaluation of anterior urethral stricture.