The adult male urethra: normal anatomy, pathology, and method of urethrography

Detailed knowledge of the normal anatomy of the urethra and adjacent structures is essential to an understanding of the normal radiologic landmarks on urethrography, and is prerequisite to the radiologic interpretation of the diseased urethra. The nature of fibrosis in the urethra must also be clearly understood, since radiologic interpretation of urethral scarring influences surgical management. No longer is it sufficient for the radiologist to delineate a tight structure in the urethra and leave the operative decision solely to clinical assessment. Dynamic retrograde urethrography allows the radiologist to direct the attention of the urologist to the membranous urethra and to the possibility that transsphincter urethroplasty may be required. While voiding urethrography is an integral part of the examination and may provide additional information, voiding urethrography without dynamic retrograde urethrography without dynamic retrograde urethrography may be misleading in that soft scarring of the urethra may be missed.