Radiographic Misdiagnoses After Periurethral Bulking Agents

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Injectable urethral bulking agents are a common treatment for stress urinary incontinence.
• Post-treatment pelvic imaging may reveal these agents, potentially leading to misinterpretation.
• Accurate identification is crucial to avoid unnecessary patient anxiety and interventions.

Purpose of the Study:

• To evaluate the incidence of misdiagnosis of urethral bulking agents on pelvic imaging.
• To identify common misinterpretations and their frequencies.
• To highlight the importance of accurate radiological assessment in patients treated with bulking agents.

Main Methods:

• Retrospective review of pelvic imaging studies from 2005-2015.
• Analysis of 528 patients who underwent urethral bulking agent injection for stress urinary incontinence.
• Review of radiological reports for descriptions of periurethral findings and their interpretations.

Main Results:

• Of 111 imaging studies with abnormal periurethral findings, 72 (65%) misinterpreted the urethral bulking agents.
• Common misdiagnoses included bladder calcification (23%), urethral diverticulum with stone (11%), and mass suspicious for malignancy (5%).
• Only 39% of studies correctly identified the bulking agents.

Conclusions:

• Urethral bulking agents are frequently misinterpreted on subsequent pelvic imaging.
• Misinterpretations can lead to the consideration of serious pathologies, necessitating further workup.
• Clear communication between clinicians and radiologists is essential for accurate diagnosis.