MR urethrogram versus combined retrograde urethrogram and sonourethrography in diagnosis of urethral stricture.

OBJECTIVES: To compare the accuracy of magnetic resonance (MR) urethrogram versus combined RUG and sonourethrography (SUG) in diagnosis urethral stricture with evaluation of their impact in management choice.

MATERIAL AND METHODS: From March 2006 through February 2007; 30 male patients (mean age, 45+/-18 years, range 15-75) with clinically suspected urethral stricture. All patients underwent RUG, SUG and MR urethrogram.

RESULTS: The final diagnosis of the 30 cases included in our study, after endoscopy and surgical management, was classified into two main groups either isolated stricture (20 cases) or associated with other pathologies (9 cases). There was one case with normal urethral caliber at endoscopy. For the anterior stricture the sensitivity, specificity and overall accuracy of RUG was 91%, 90% and 90%, respectively and for the posterior stricture it was 89%, 91.7% and 90%, respectively. At SUG, all cases of anterior were detected with 100% accuracy while for cases of posterior stricture, the overall accuracy was 60%. MR urethrogram diagnosed all the cases of anterior and posterior stricture with exact delineation of its length except one case of normal caliber was diagnosed falsely at MR as anterior short segment urethral with 100% sensitivity, 91.7% specificity and 95% overall accuracy.

CONCLUSION: MR urethrogram has comparable results with the combined RUG and SUG in diagnosing the anterior and posterior urethral strictures as regard the site and extension and degree of spongiofibrosis but MR is superior in diagnosis of associated pathologies with stricture.