Skip to main content
SpringerLink
Log in

MR urethrography versus X-ray urethrography compared with operative findings for the evaluation of urethral strictures

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

We compared the accuracy of magnetic resonance (MR) urethrography and X-ray urethrography with operative findings for urethral strictures and observed their effects on treatment.

Materials and methods

A total of 87 male patients (10–85 years of age) treated from January 2015 to December 2016 were included in the study. X-ray and MR urethrograms were performed for all patients to determine the location, length, and degree of urethral strictures and the organizational structure around the urethra, and the results were compared with the operative findings. One-way analysis of variance (ANOVA) was performed to compare the lengths of the urethral strictures determined by the two methods with the operative findings. A value of P < 0.05, calculated using GraphPad software, indicated statistical significance.

Results

Urethral stricture was more clearly shown on MR urethrography than on X-ray urethrography. The stricture length measured by conventional X-ray urethrography [(2.17 ± 0.65) cm] was much longer than that measured by MR urethrography [(1.68 ± 0.67) cm]. The surgical findings [(1.66 ± 0.70) cm] were significantly different from X-ray urethrography findings (F = 24.660, P = 0.000), but no significant difference was observed between the surgical findings and the stricture length measured by MR urethrography (F = 0.040, P = 0.842).

Conclusion

Urethral strictures can be displayed more clearly and accurately by MR urethrography than by X-ray urethrography. MR urethrography is expected to become a necessary and standard procedure for the preoperative examination of urethral strictures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gomez RG, Mundy T, Dubey D, El-Kassaby AW, Firdaoessaleh Kodama R, Santucci R (2014) SIU/ICUD consultation on urethral strictures: pelvic fracture urethral injuries. Urology 83(3 Suppl):S48–S58

    Article  PubMed  Google Scholar 

  2. Mongha R, Kumar A (2009) Changing concept of urethral stricture disease. Apollo Med 6(2):152–155

    Article  Google Scholar 

  3. Kizilay F, Simsir A, Ozyurt C (2017) Analysis of recurrent urethral strictures due to iatrogenic urethral trauma. Turk J Med Sci 47(5):1543–1548

    Article  PubMed  Google Scholar 

  4. Anger JT, Buckley JC, Santucci RA, Elliott SP, Saigal CS, Urologic Diseases in America P (2011) Trends in stricture management among male Medicare beneficiaries: underuse of urethroplasty? Urology 77(2):481–485

    Article  PubMed  Google Scholar 

  5. Hillary CJ, Osman NI, Chapple CR (2014) Current trends in urethral stricture management. Asian J Urol 1(1):46–54

    Article  PubMed  Google Scholar 

  6. Vetterlein MW, Weisbach L, Riechardt S, Fisch M (2019) Anterior urethral strictures in children: disease etiology and comparative effectiveness of endoscopic treatment vs. open surgical reconstruction. Front Pediatr 7:5

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wessells H, Angermeier KW, Elliott S, Gonzalez CM, Kodama R, Peterson AC, Reston J, Rourke K, Stoffel JT, Vanni AJ, Voelzke BB, Zhao L, Santucci RA (2017) Male urethral stricture: American Urological Association guideline. J Urol 197(1):182–190

    Article  PubMed  Google Scholar 

  8. Lv XG, Peng XF, Feng C, Xu YM, Shen YL (2016) The application of CT voiding urethrography in the evaluation of urethral stricture associated with fistula: a preliminary report. Int Urol Nephrol 48(8):1267–1273

    Article  PubMed  Google Scholar 

  9. Kogan MI, Banchik EL, Dombrovsky VI, Mitusov V (2013) 787 Value of MRI in diagnostic study in patients with urethral stricture: impact on subsequent surgery. Eur Urol Suppl 12(1):e787–e787

    Article  Google Scholar 

  10. Heidenreich A, Derschum W, Bonfig R, Wilbert DM (1994) Ultrasound in the evaluation of urethral stricture disease: a prospective study in 175 patients. Br J Urol 74(1):93–98

    Article  CAS  PubMed  Google Scholar 

  11. Pavlica P, Menchi I, Barozzi L (2003) New imaging of the anterior male urethra. Abdom Imaging 28(2):180–186

    Article  CAS  PubMed  Google Scholar 

  12. McAninch JW, Laing FC, Jeffrey RB Jr (1988) Sonourethrography in the evaluation of urethral strictures: a preliminary report. J Urol 139(2):294–297

    Article  CAS  PubMed  Google Scholar 

  13. Sung DJ, Kim YH, Cho SB, Oh YW, Lee NJ, Kim JH, Chung KB, du Moon G, Kim JJ (2006) Obliterative urethral stricture: MR urethrography versus conventional retrograde urethrography with voiding cystourethrography. Radiology 240(3):842–848

    Article  PubMed  Google Scholar 

  14. El-Ghar MA, Osman Y, Elbaz E, Refiae H, El-Diasty T (2010) MR urethrogram versus combined retrograde urethrogram and sonourethrography in diagnosis of urethral stricture. Eur J Radiol 74(3):e193–e198

    Article  PubMed  Google Scholar 

  15. Stein DM, Thum DJ, Barbagli G, Kulkarni S, Sansalone S, Pardeshi A, Gonzalez CM (2013) A geographic analysis of male urethral stricture aetiology and location. BJU Int 112(6):830–834

    Article  PubMed  Google Scholar 

  16. Lumen N, Kuehhas FE, Djakovic N, Kitrey ND, Serafetinidis E, Sharma DM, Summerton DJ (2015) Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol 67(5):925–929

    Article  PubMed  Google Scholar 

  17. Cogorno Wasylkowski L, Rios Gonzalez E, Martinez-Pineiro Lorenzo L (2016) Diagnosis of urethral stenosis and follow-up after Urethroplasty. Arch Esp Urol 69(7):416–422

    CAS  PubMed  Google Scholar 

  18. El-Bab TKF, Galal EM, Abdelhamid AM, Amin MF (2015) Magnetic resonance urethrography versus conventional retrograde urethrography in the evaluation of urethral stricture: comparison with surgical findings. Egypt J Radiol Nucl Med 46(1):199–204

    Article  Google Scholar 

  19. Launonen E, Sairanen J, Ruutu M, Taskinen S (2014) Role of visual internal urethrotomy in pediatric urethral strictures. J Pediatr Urol 10(3):545–549

    Article  PubMed  Google Scholar 

  20. Deng T, Liao B, Luo D, Liu B, Wang K, Liu J, Jin T (2015) Management for the anterior combined with posterior urethral stricture: a 9-year single centre experience. Int J Clin Exp Med 8(3):3912–3923

    PubMed  PubMed Central  Google Scholar 

  21. Yasser O, Mohamed Abou EG, Osama M, Huda R, Tarek ED (2006) Magnetic resonance urethrography in comparison to retrograde urethrography in diagnosis of male urethral strictures: is it clinically relevant? Eur Urol 50(3):587–594

    Article  Google Scholar 

  22. Itani M, Kielar A, Menias CO, Dighe MK, Surabhi V, Prasad SR, O’Malley R, Gangadhar K, Lalwani N (2016) MRI of female urethra and periurethral pathologies. Int Urogynecol J 27(2):195–204

    Article  PubMed  Google Scholar 

  23. Osman NI, Altaf M, Chapple CR (2013) A systematic review of surgical techniques used in the treatment of female urethral stricture. Eur Urol 64(6):965–973

    Article  PubMed  Google Scholar 

  24. Kulkarni SB, Joshi PM, Hunter C, Surana S, Shahrour W, Alhajeri F (2015) Complex posterior urethral injury. Arab J Urol 13(1):43–52

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fichtner J, Filipas D, Fisch M, Hohenfellner R, Thuroff JW (2004) Long-term outcome of ventral buccal mucosa onlay graft urethroplasty for urethral stricture repair. Urology 64(4):648–650

    Article  PubMed  Google Scholar 

  26. Gupta S, Roy S, Pal DK (2018) Efficacy of oral steroids after optical internal urethrotomy in reducing recurrence of urethral strictures. Turk J Urol 44(1):42–44

    Article  PubMed  Google Scholar 

  27. Tavakkoli Tabassi K, Yarmohamadi A, Mohammadi S (2011) Triamcinolone injection following internal urethrotomy for treatment of urethral stricture. Urol J 8(2):132–136

    PubMed  Google Scholar 

  28. Hillary CJ, Osman NI, Hilton P, Chapple CR (2016) The aetiology, treatment, and outcome of urogenital fistulae managed in well- and low-resourced countries: a systematic review. Eur Urol 70(3):478–492

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

All authors thank Ms. Hui Ji, an MRI technician in the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University.

Author information

Authors and Affiliations

  1. Department of Radiology, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Beijing West Road No. 6, Huai’an, 223300, Jiangsu, People’s Republic of China

    Weijing Tao & Genji Bai

  2. Department of Urology Surgery, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Huai’an, 223300, Jiangsu, People’s Republic of China

    Guangbo Fu, Xiaobing Niu, Hengbing Wang & Gongcheng Wang

Authors
  1. Weijing Tao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Genji Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guangbo Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaobing Niu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hengbing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gongcheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Genji Bai.

Ethics declarations

Conflict of interest

The authors declare no competing financial interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tao, W., Bai, G., Fu, G. et al. MR urethrography versus X-ray urethrography compared with operative findings for the evaluation of urethral strictures. Int Urol Nephrol 51, 1137–1143 (2019). https://doi.org/10.1007/s11255-019-02162-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-019-02162-w

Keywords

Search

Navigation