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Clinical Presentation and Diagnostic Evaluation of Male Urethral Stricture

  • Alvaro A. Saavedra
  • Keith F. RourkeEmail author
Chapter

Abstract

Primary diagnosis of urethral strictures mostly relies on the presence of certain risk factors in the context of bladder outlet obstruction, that lead to further investigation. Findings on physical examination, patient-reported assessments, uroflowmetry, and post-void residual determination can raise suspicion of a stricture, but are not sufficient for diagnostic confirmation. Definitive diagnosis of urethral narrowing is based on cystoscopy, while staging, characteristics determination, and surgical planning is typically made using retrograde/voiding urethrogram. Evidence supporting the use of urethral ultrasound for anterior strictures has been growing considerably and may be even considered as surrogate for urethrogram in some specific settings. More recently, both urethral magnetic resonance, along with urethral computed tomography have proven to be helpful for complex cases of pelvic fracture urethral injuries, fistulas, and posterior urethral strictures.

Regarding follow-up studies after surgical repair, it has been recommended to use periodical patient-reported outcome measurements including not only voiding features, but also sexual, overall satisfaction, and quality of life fields, since, besides voiding function, urethroplasty may impact on several aspects of patients’ daily life. Currently, a comprehensive tool incorporating all these aspects does not exist yet. Additionally, uroflowmetry and post-void residual measurement should be performed on a regular basis. Nonetheless, cystoscopic evaluation should be done around 3 months and between 12 and 18 months postoperatively, because some recurrences may not be detected by the above-mentioned assessments. If a stricture recurrence is detected, then urethrogram is mandatory for staging and further surgical planning.

Keywords

Urethral stricture/diagnosis Urethra/diagnostic imaging Urethroplasty Cystoscopy Patient reported outcome measures Urethral diseases Urethrogram Tomography X-ray computed Magnetic resonance imaging Ultrasonography Quality of life 

References

  1. 1.
    Blandy JP. Urethral stricture. Postgred Med J. 1980;56:383–418.Google Scholar
  2. 2.
    Cunningham J. The diagnosis of stricture of the urethra by Roentgen rays. Trans Am Assoc Genitourin Surg. 1910;5:369–71.Google Scholar
  3. 3.
    Moran ME, Moll FH. The history of technologic advancements in urology [Internet]. Patel SR, Moran ME, Nakada SY, editors. Cham: Springer International Publishing; 2018. p. 3–20. Available from: http://link.springer.com/10.1007/978-3-319-61691-9
  4. 4.
    Rourke K, Hickle J. The clinical spectrum of the presenting signs and symptoms of anterior urethral stricture: Detailed analysis of a single institutional cohort. Urology [Internet]. Elsevier; 2012;79(5):1163–7. Available from:  https://doi.org/10.1016/j.urology.2012.01.044.PubMedGoogle Scholar
  5. 5.
    Rourke K. The epidemiology, clinical presentation, and economic burden of urethral stricture. In: Brandes SB, Morey AF, editors. New York: Humana Press; 2014 [cited 2018 Jul 20]. p. 83–93. Available from: http://link.springer.com/10.1007/978-1-4614-7708-2_7
  6. 6.
    Mundy AR, Andrich DE. Urethral strictures. BJU Int. 2011;107(1):6–26.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Palminteri E, Berdondini E, Verze P, De Nunzio C, Vitarelli A, Carmignani L. Contemporary urethral stricture characteristics in the developed world. Urology [Internet]. Elsevier; 2013;81(1):191–6. Available from:  https://doi.org/10.1016/j.urology.2012.08.062.Google Scholar
  8. 8.
    Wessells H, Angermeier KW, Elliott S, Gonzalez CM, Kodama R, Peterson AC, et al. Male urethral stricture: American urological association guideline. J Urol [Internet]. Elsevier; 2017 [cited 2018 Jul 23];197(1):182–90. Available from:  https://doi.org/10.1016/j.juro.2016.07.087.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Bayne DB, Gaither TW, Awad MA, Murphy GP, Osterberg EC, Breyer BN. Guidelines of guidelines: a review of urethral stricture evaluation, management, and follow-up. Transl Androl Urol [Internet]. 2017;6(2):288–94. Available from: http://tau.amegroups.com/article/view/14057/14810 PubMedPubMedCentralGoogle Scholar
  10. 10.
    Jordan G, Chapple C, Heyns C. Proceedings of International Consultation on Urologic Diseases: Urethral Strictures, International Consultation on Urethral Strictures, in conjunction with the Société Internationale d’Urologie (SIU) World Meeting, 13–16 October 2010, Marrakech, Morocco. Urology. 2014;83(3 Suppl):S1–73.Google Scholar
  11. 11.
    Nuss GR, Granieri MA, Zhao LC, Thum DJ, Gonzalez CM. Presenting symptoms of anterior urethral stricture disease: a disease specific, patient reported questionnaire to measure outcomes. J Urol [Internet] Elsevier; 2012;187(2):559–62. Available from:  https://doi.org/10.1016/j.juro.2011.10.043.PubMedGoogle Scholar
  12. 12.
    Plante M, Corcos J, Gregoire I, Belanger MF, Brock G, Rossingol M. The international prostate symptom score: physician versus self-administration in the quantification of symptomatology. Urology [Internet]. 1996 [cited 2018 Jul 26];47(3):326–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8633396 PubMedGoogle Scholar
  13. 13.
    Arocho R, Kason NM, Colón B, McMillan CA. Translation and validation of the American urological association symptom index into Spanish. Clin Ther [Internet]. [cited 2018 Jul 26];17(4):777–85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8565040 PubMedGoogle Scholar
  14. 14.
    Grégoire JP, Moisan J, Labrecque M, Cusan L, Diamond P. [Validation of a French adaptation of the international prostatic symptom score]. Prog Urol [Internet]. 1996 [cited 2018 Jul 26];6(2):240–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8777417
  15. 15.
    Moore C, Kogan BA, Parekh A. Impact of urinary incontinence on self-concept in children with spina bifida. J Urol. 2004;171(4):1659–62.PubMedGoogle Scholar
  16. 16.
    Barry MJ, Fowler FJ, Chang Y, Liss CL, Wilson H, Stek M. The American urological association symptom index: does mode of administration affect its psychometric properties? J Urol [Internet]. 1995 [cited 2018 Jul 26];154(3):1056–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7543597 PubMedGoogle Scholar
  17. 17.
    Netto Júnior NR, de Lima ML. The influence of patient education level on the international prostatic symptom score. J Urol [Internet]. 1995 [cited 2018 Jul 26];154(1):97–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7539870 Google Scholar
  18. 18.
    Morey AF, McAninch JW, Duckett CP, Rogers RS. American urological association symptom index in the assessment of urethroplasty outcomes. J Urol [Internet]. 1998 [cited 2018 Jul 23];159(4):1192–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9507830 PubMedGoogle Scholar
  19. 19.
    Yalla S V, Sullivan MP, Lecamwasam HS, DuBeau CE, Vickers MA, Cravalho EG. Correlation of American urological association symptom index with obstructive and nonobstructive prostatism. J Urol [Internet]. 1995 [cited 2018 Jul 26];153(3 Pt 1):674–9; discussion 679–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7532231
  20. 20.
    Chancellor MB, Rivas DA, Keeley FX, Lotfi MA, Gomella LG. Similarity of the American urological association symptom index among men with benign prostate hyperplasia (BPH), urethral obstruction not due to BPH and detrusor hyperreflexia without outlet obstruction. Br J Urol [Internet]. 1994 [cited 2018 Jul 26];74(2):200–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7522872 PubMedGoogle Scholar
  21. 21.
    Roberts RO, Jacobsen SJ, Jacobson DJ, Reilly WT, Talley NJ, Lieber MM. Natural history of prostatism: high American urological association symptom scores among community-dwelling men and women with urinary incontinence. Urology [Internet]. 1998 [cited 2018 Jul 26];51(2):213–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9495700 PubMedGoogle Scholar
  22. 22.
    Meeks JJ, Erickson BA, Granieri MA, Gonzalez CM. Stricture recurrence after urethroplasty: A systematic review. J Urol [Internet]. Elsevier; 2009 [cited 2018 Jul 17];182(4 SUPPL.):1266–70. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534709014967
  23. 23.
    Heyns CF, Marais DC. Prospective evaluation of the American urological association symptom index and peak urinary flow rate for the followup of men with known urethral stricture disease. J Urol [Internet]. 2002 [cited 2018 Jul 17];168(5):2051–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12394706 PubMedGoogle Scholar
  24. 24.
    Tam CA, Voelzke BB, Elliott SP, Myers JB, McClung CD, Vanni AJ, et al. Critical analysis of the use of uroflowmetry for urethral stricture disease surveillance. Urology [Internet]. NIH Public Access; 2016 [cited 2018 Jul 23];91:197–202. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26873640
  25. 25.
    Tam CA, Elliott SP, Voelzke BB, Myers JB, Vanni AJ, Breyer BN, et al. The international prostate symptom score (IPSS) is an inadequate tool to screen for urethral stricture recurrence after anterior urethroplasty. Urology [Internet] 2016 [cited 2018 Jul 17];95:197–201. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0090429516300942
  26. 26.
    Erickson BA, Elliott SP, Voelzke BB, Myers JB, Broghammer JA, Smith TG, et al. Multi-institutional 1-year bulbar urethroplasty outcomes using a standardized prospective cystoscopic follow-up protocol. Urology. 2014;84(1):213–6.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Jackson MJ, N’Dow J, Pickard R. The importance of patient-reported outcome measures in reconstructive urology. Curr Opin Urol. 2010;20(6):495–9.PubMedGoogle Scholar
  28. 28.
    Kessler TM, Fisch M, Heitz M, Olianas R, Schreiter F. Patient satisfaction with the outcome of surgery for urethral stricture. J Urol. 2002;167(6):2507–11.Google Scholar
  29. 29.
    Bertrand LA, Voelzke BB, Elliott SP, Myers JB, Breyer BN, Vanni AJ, et al. Measuring and predicting patient dissatisfaction after anterior urethroplasty using patient reported outcomes measures. J Urol [Internet]. Elsevier; 2016 [cited 2018 Aug 7];196(2):453–61. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534716003517 PubMedGoogle Scholar
  30. 30.
    Maciejewski CC, Haines T, Rourke KF. Chordee and penile shortening rather than voiding function are associated with patient dissatisfaction after Urethroplasty. Urology [Internet] Elsevier; 2017;103:234–9. Available from:  https://doi.org/10.1016/j.urology.2016.12.047.PubMedGoogle Scholar
  31. 31.
    Jackson MJ, Sciberras J, Mangera A, Brett A, Watkin N, N’Dow JMO, et al. Defining a patient-reported outcome measure for urethral stricture surgery. Eur Urol. 2011;60(1):60–8.Google Scholar
  32. 32.
    Breyer BN, Edwards TC, Patrick DL, Voelzke BB. Comprehensive qualitative assessment of urethral stricture disease: toward the development of a patient centered outcome measure. J Urol [Internet]. Elsevier; 2017;198(5):1113–8. Available from:  https://doi.org/10.1016/j.juro.2017.05.077.PubMedGoogle Scholar
  33. 33.
    Coursey JW, Morey AF, McAninch JW, Summerton DJ, Secrest C, White P, et al. Erectile function after anterior urethroplasty. J Urol. 2001;166(6):2273–6.Google Scholar
  34. 34.
    MacDiarmid SA, Goodson TC, Holmes TM, Martin PR, Doyle RB. An assessment of the comprehension of the American urological association symptom index. J Urol [Internet]. 1998 [cited 2018 Jul 30];159(3):873–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9474172 PubMedGoogle Scholar
  35. 35.
    Johnson TV., Abbasi A, Ehrlich SS, Kleris RS, Schoenberg ED, Owen-Smith A, et al. Patient misunderstanding of the individual questions of the American urological association symptom score. J Urol [Internet]. 2008 [cited 2018 Jul 30];179(6):2291–5. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534708002851 PubMedGoogle Scholar
  36. 36.
    Van Der Walt CLE, Heyns CF, Groeneveld AE, Edlin RS, Van Vuuren SPJ. Prospective comparison of a new visual prostate symptom score versus the international prostate symptom score in men with lower urinary tract symptoms. Urology [Internet]. Elsevier; 2011;78(1):17–20. Available from:  https://doi.org/10.1016/j.urology.2011.01.065.PubMedGoogle Scholar
  37. 37.
    Wessels SG, Heyns CF. Prospective evaluation of a new visual prostate symptom score, the international prostate symptom score, and uroflowmetry in men with urethral stricture disease. Urology [Internet]. Elsevier; 2014;83(1):220–4. Available from:  https://doi.org/10.1016/j.urology.2013.08.058.PubMedGoogle Scholar
  38. 38.
    Yucel S, Baskin LS. Neuroanatomy of the male urethra and perineum. BJU Int. 2003;92(6):624–30.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Yucel S, Baskin LS. Identification of communicating branches among the dorsal, perineal and cavernous nerves of the penis. J Urol. 2003;170(1):153–8.PubMedGoogle Scholar
  40. 40.
    Dalpiaz O, Mitterberger M, Kerschbaumer A, Pinggera GM, Bartsch G, Strasser H. Anatomical approach for surgery of the male posterior urethra. BJU Int. 2008;102(10):1448–51.PubMedPubMedCentralGoogle Scholar
  41. 41.
    Dogra PN, Singh P, Nayyar R, Yadav S. Sexual dysfunction after urethroplasty. Urol Clin North Am [Internet]. Elsevier; 2017;44(1):49–56. Available from:  https://doi.org/10.1016/j.ucl.2016.08.013.PubMedGoogle Scholar
  42. 42.
    Erickson BA, Granieri MA, Meeks JJ, Cashy JP, Gonzalez CM. Prospective analysis of erectile dysfunction after anterior urethroplasty: incidence and recovery of function. J Urol [Internet]. Elsevier; 2010;183(2):657–61. Available from:  https://doi.org/10.1016/j.juro.2009.10.017.PubMedGoogle Scholar
  43. 43.
    Anger JT, Sherman ND, Webster GD. The effect of bulbar urethroplasty on erectile function. J Urol. 2007;178(3):1009–11.PubMedGoogle Scholar
  44. 44.
    Erickson BA, Wysock JS, McVary KT, Gonzalez CM. Erectile function, sexual drive, and ejaculatory function after reconstructive surgery for anterior urethral stricture disease. BJU Int. 2007;99(3):607–11.PubMedGoogle Scholar
  45. 45.
    Blaschko SD, Sanford MT, Cinman NM, McAninch JW, Breyer BN. De novo erectile dysfunction after anterior urethroplasty: a systematic review and meta-analysis. BJU Int. 2013;112(5):655–63.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Sachin D, ChikkaMoga Siddaiah M, Vilvapathy Senguttuvan K, Chandrashekar Sidaramappa R, Ramaiah K. Incidence of De novo erectile dysfunction after Urethroplasty: a prospective observational study. World J Mens Health. 2017;35(2):94–9.PubMedPubMedCentralGoogle Scholar
  47. 47.
    Shenfeld OZ, Kiselgorf D, Gofrit ON, Verstandig AG, Landau EH, Pode D. The incidence and causes of erectile dysfunction after pelvic fractures associated with posterior urethral disruption. J Urol [Internet]. 2003 [cited 2018 Aug 29];169(6):2173–2176. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534705635562 PubMedGoogle Scholar
  48. 48.
    Anger JT, Sherman ND, Dielubanza E, Webster GD. Erectile function after posterior urethroplasty for pelvic fracture-urethral distraction defect injuries. BJU Int. 2009;104(8):1126–9.PubMedGoogle Scholar
  49. 49.
    Koraitim MM. Predictors of erectile dysfunction post pelvic fracture urethral injuries: a multivariate analysis. Urology [Internet]. Elsevier; 2013;81(5):1081–5. Available from:  https://doi.org/10.1016/j.urology.2012.12.040.Google Scholar
  50. 50.
    Fu Q, Zhang J, Sa YL, Jin SB, Xu YM. Recurrence and complications after transperineal bulboprostatic anastomosis for posterior urethral strictures resulting from pelvic fracture: a retrospective study from a urethral referral Centre. BJU Int. 2013;112(4):358–63.Google Scholar
  51. 51.
    Blaschko SD, Sanford MT, Schlomer BJ, Alwaal A, Yang G, Villalta JD, et al. The incidence of erectile dysfunction after pelvic fracture urethral injury: a systematic review and meta-analysis. Arab J Urol [internet]. Arab association of Urology; 2015;13(1):68–74. Available from:  https://doi.org/10.1016/j.aju.2014.09.004.PubMedGoogle Scholar
  52. 52.
    Wright JL, Nathens AB, Rivara FP, MacKenzie EJ, Wessells H. Specific fracture configurations predict sexual and excretory dysfunction in men and women 1 year after pelvic fracture. J Urol [Internet]. 2006 [cited 2018 Aug 29];176(4):1540–5. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534706014200 PubMedGoogle Scholar
  53. 53.
    Feng C, Xu YM, Barbagli G, Lazzeri M, Tang CY, Fu Q, et al. The relationship between erectile dysfunction and open urethroplasty: a systematic review and meta-analysis. J Sex Med. 2013;10(8):2060–8.PubMedGoogle Scholar
  54. 54.
    Pratap A, Agrawal CS, Pandit RK, Sapkota G, Anchal N. Factors contributing to a successful outcome of combined abdominal Transpubic perineal Urethroplasty for complex posterior urethral disruptions. J Urol [Internet]. 2006 [cited 2018 Aug 29];176(6):2514–2517. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534706019641 PubMedGoogle Scholar
  55. 55.
    KORAITIM MM. On the art of anastomotic posterior urethroplasty: a 27-year experience. J Urol [Internet]. 2005 [cited 2018 Aug 29];173(1):135–139. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534705607975
  56. 56.
    Morey AF, McAninch JW. Reconstruction of posterior urethral disruption injuries: outcome analysis in 82 patients. J Urol [Internet]. 1997 [cited 2018 Aug 29];157(2):506–510. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8996343
  57. 57.
    Alwaal A, Breyer BN, Lue TF. Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril [Internet] Elsevier; 2015;104(5):1051–60. Available from:  https://doi.org/10.1016/j.fertnstert.2015.08.033.PubMedPubMedCentralGoogle Scholar
  58. 58.
    Yang CC, Bradley WE. Reflex innervation of the bulbocavernosus muscle. BJU Int. 2000;85(7):857–63.PubMedGoogle Scholar
  59. 59.
    Kaluzny A, Gibas A, Matuszewski M. Ejaculatory disorders in men with urethral stricture and impact of urethroplasty on the ejaculatory function: a systematic review. J Sex Med [Internet]. Elsevier; 2018;15(7):974–81. Available from:  https://doi.org/10.1016/j.jsxm.2018.05.005.PubMedGoogle Scholar
  60. 60.
    Erickson BA, Breyer BN, McAninch JW. Changes in uroflowmetry maximum flow rates after urethral reconstructive surgery as a means to predict for stricture recurrence. J Urol [Internet]. Elsevier; 2011;186(5):1934–7. Available from:  https://doi.org/10.1016/j.juro.2011.07.010.PubMedGoogle Scholar
  61. 61.
    Anger JT, Sherman ND, Webster GD. Ejaculatory profiles and fertility in men after posterior urethroplasty for pelvic fracture-urethral distraction defect injuries. BJU Int [Internet] 2008 [cited 2018 Aug 30];102(3):351–353. Available from: http://doi.wiley.com/10.1111/j.1464-410X.2008.07657.x.
  62. 62.
    El-Assmy A, Benhassan M, Harraz AM, Nabeeh A, Ibrahiem EHI. Ejaculatory function after anastomotic urethroplasty for pelvic fracture urethral injuries. Int Urol Nephrol [Internet]. 2015 [cited 2018 Aug 8];47(3):497–501. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25655257 PubMedGoogle Scholar
  63. 63.
    Feneley MR, Dunsmuir WD, Pearce J, Kirby RS. Reproducibility of uroflow measurement: experience during a double-blind, placebo-controlled study of doxazosin in benign prostatic hyperplasia. Urology [Internet]. 1996 [cited 2018 Sep 5];47(5):658–63. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8650862 PubMedGoogle Scholar
  64. 64.
    Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol [Internet] 2005;7 Suppl 6:S14–21. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1477621&tool=pmcentrez&rendertype=abstract
  65. 65.
    Chancellor MB, Blaivas JG, Kaplan SA, Axelrod S. Bladder outlet obstruction versus impaired detrusor contractility: the role of outflow. J Urol [Internet]. 1991 Apr [cited 2018 Sep 5];145(4):810–812. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2005706 PubMedGoogle Scholar
  66. 66.
    Abrams P. Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int [Internet]. 1999 [cited 2018 Sep 5];84(1):14–15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10444116 PubMedGoogle Scholar
  67. 67.
    Lambert E, Denys M-A, Poelaert F, Everaert K, Lumen N. Validated uroflowmetry-based predictive model for the primary diagnosis of urethral stricture disease in men. Int J Urol [Internet] 2018 [cited 2018 Oct 25];25(9):1–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30021245.PubMedGoogle Scholar
  68. 68.
    Angermeier KW, Rourke KF, Dubey D, Forsyth RJ, Gonzalez CM. SIU/ICUD consultation on urethral strictures: evaluation and follow-up. Urology [Internet]. Elsevier; 2014;83(3 Suppl.):S8–17. Available from:  https://doi.org/10.1016/j.urology.2013.09.011.Google Scholar
  69. 69.
    Erickson BA, Breyer BN, McAninch JW. The use of uroflowmetry to diagnose recurrent stricture after urethral reconstructive surgery. J Urol [Internet]. Elsevier; 2010 [cited 2018 Sep 7];184(5):1386–90. Available from:  https://doi.org/10.1016/j.juro.2010.06.015.PubMedGoogle Scholar
  70. 70.
    Erickson BA, Ghareeb GM. Definition of successful treatment and optimal follow-up after urethral reconstruction for urethral stricture disease. Urol Clin North Am [Internet]. Elsevier; 2017;44(1):1–9. Available from:  https://doi.org/10.1016/j.ucl.2016.08.001.PubMedGoogle Scholar
  71. 71.
    Johnson T V., Abbasi A, Ehrlich SS, Kleris RS, Schoenberg ED, Owen-Smith A, et al. No title. J Urol [Internet] 2008 Jun [cited 2018 Jul 30];179(6):2291–2295. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0022534708002851
  72. 72.
    Choudhary S, Singh P, Sundar E, Kumar S, Sahai A. A comparison of sonourethrography and retrograde urethrography in evaluation of anterior urethral strictures. Clin Radiol. 2004;59(8):736–42.PubMedGoogle Scholar
  73. 73.
    Smith JC. Urethral resistance to micturition. Br J Urol [Internet] 1968 Apr [cited 2018 Sep 7];40(2):125–156. Available from: http://www.ncbi.nlm.nih.gov/pubmed/5653005
  74. 74.
    Goonesinghe SK, Hillary CJ, Nicholson TR, Osman NI, Chapple CR. Flexible cystourethroscopy in the follow-up of posturethroplasty patients and characterisation of recurrences. Eur Urol [internet]. European association of Urology; 2015;68(3):523–9. Available from:  https://doi.org/10.1016/j.eururo.2015.04.013.PubMedGoogle Scholar
  75. 75.
    Lavoie C, Rourke KF. MP–6.3. Optimal preoperative staging of penile urethral stricture length: the critical role of pediatric cystoscopy. Can Urol Assoc J. 2018;12(6Suppl2):S96.Google Scholar
  76. 76.
    Yeung LL, Brandes SB. Urethroplasty practice and surveillance patterns: a survey of reconstructive urologists. Urology [Internet]. Elsevier; 2013;82(2):471–5. Available from:  https://doi.org/10.1016/j.urology.2013.03.069.PubMedGoogle Scholar
  77. 77.
    Zaid UB, Hawkins M, Wilson L, Ting J, Harris C, Alwaal A, et al. The cost of surveillance after Urethroplasty. Urology. 2015;85(5):1195–9.PubMedPubMedCentralGoogle Scholar
  78. 78.
    Hart D, Wall BF. UK population dose from medical X-ray examinations. Eur J Radiol [Internet]. 2004. [cited 2018 Oct 9];50(3):285–291. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15145489 PubMedGoogle Scholar
  79. 79.
    Wood DN, Andrich DE, Greenwell TJ, Mundy AR. Standing the test of time: the long-term results of urethroplasty. World J Urol [Internet]. 2006 [cited 2018 Sep 14];24(3):250–254. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16508787 PubMedGoogle Scholar
  80. 80.
    Belsante MJ, Zhao LC, Hudak SJ, Lotan Y, Morey AF. Cost-effectiveness of risk stratified Followup after urethral reconstruction : a decision analysis. J Urol [Internet] Elsevier; 2013;190(4):1292–7. Available from:  https://doi.org/10.1016/j.juro.2013.04.024.PubMedGoogle Scholar
  81. 81.
    Mahmud SM, El KS, Rana AM, Zaidi Z. Is ascending urethrogram mandatory for all urethral strictures ? J Pak Med Assoc. 2008;58(8):429–31.PubMedGoogle Scholar
  82. 82.
    Peskar DB, Perovič AV. Comparison of radiographic and sonographic urethrography for assessing urethral strictures. Eur Radiol. 2004;14(1):137–44.Google Scholar
  83. 83.
    Koraitim MM. Assessment and management of an open bladder neck at posterior urethroplasty. Urology [Internet]. Elsevier; 2010;76(2):476–9. Available from:  https://doi.org/10.1016/j.urology.2009.11.043.PubMedGoogle Scholar
  84. 84.
    Bach P, Rourke K. Independently interpreted retrograde urethrography does not accurately diagnose and stage anterior urethral stricture: the importance of urologist-performed urethrography. Urology [Internet]. Elsevier; 2014;83(5):1190–3. Available from:  https://doi.org/10.1016/j.urology.2013.12.063.PubMedGoogle Scholar
  85. 85.
    Kulkarni S, Joshi P. Imaging in stricture urethra. In: Gulia R, Santucci R, Kulkarni SB, editors. Atlas of urethroplasty. 1st ed. New Delhi: JP Brothers Medical Publishers; 2014. p. 19–27.Google Scholar
  86. 86.
    Maciejewski C, Rourke K. Imaging of urethral stricture disease. Transl Androl Urol [Internet] 2015;4(1):2–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708283/pdf/tau-04-01-002.pdf
  87. 87.
    McAninch JW, Laing FC, Jeffrey RB. Sonourethrography in the evaluation of urethral strictures: a preliminary report. J Urol [Internet]. 1988 [cited 2018 Sep 24];139(2):294–297. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3276926 PubMedGoogle Scholar
  88. 88.
    Merkle W, Wagner W. Sonography of the distal male urethra – a new diagnostic procedure for urethral strictures: results of a retrospective study. J Urol [Internet]. 1988 [cited 2018 Sep 24];140(6):1409–1411. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3057226 PubMedGoogle Scholar
  89. 89.
    Gupta S, Majumdar B, Tiwari A, Gupta RK, Kumar A, Gujral RB. Sonourethrography in the evaluation of anterior urethral strictures: correlation with radiographic urethrography. J Clin Ultrasound [Internet]. 1993 [cited 2018 Sep 24];21(4):231–239. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8478455 PubMedGoogle Scholar
  90. 90.
    Shaida N, Berman LH. Ultrasound of the male anterior urethra. Br J Radiol [Internet]. 2012 [cited 2018 Sep 24];85(special_issue_1):S94–101. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22674713
  91. 91.
    Ravikumar BR, Tejus C, Madappa KM, Prashant D, Dhayanand GS. A comparative study of ascending urethrogram and sono-urethrogram in the evaluation of stricture urethra. Int Braz J Urol. 2015;41(2):388–92.PubMedGoogle Scholar
  92. 92.
    Tembhekar NG, Sonawane BD, Mashirkar A, Titare PU, Anand A, Rathod PB. Sonourethrographic assessment of urethral obstruction. J Evol Med Dent Sci [Internet] 2014;3(64):13971–13978. Available from: http://www.jemds.com/data_pdf/1_NarendraTembhekar---------shree.pdf Google Scholar
  93. 93.
    Heidenreich A, Derschum W, Bonfig R, Wilbert DM. Ultrasound in the evaluation of urethral stricture disease: a prospective study in 175 patients. Br J Urol [Internet]. 1994 [cited 2018 Oct 4];74(1):93–98. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8044532 PubMedGoogle Scholar
  94. 94.
    Mitterberger M, Christian G, Pinggera GM, Bartsch G, Strasser H, Pallwein L, et al. Gray scale and color Doppler sonography with extended field of view technique for the diagnostic evaluation of anterior urethral strictures. J Urol. 2007;177(3):992–7.PubMedGoogle Scholar
  95. 95.
    Bryk DJ, Khurana K, Yamaguchi Y, Kozirovsky M, Telegrafi S, Zhao LC. Outpatient ultrasound urethrogram for assessment of anterior urethral stricture: early experience. Urology [Internet]. Elsevier; 2016;93:203–7. Available from:  https://doi.org/10.1016/j.urology.2016.03.016.PubMedGoogle Scholar
  96. 96.
    Oh MM, Jin MH, Sung DJ, Yoon DK, Kim JJ, Moon DG. Magnetic resonance urethrography to assess obliterative posterior urethral stricture: comparison to conventional retrograde urethrography with voiding cystourethrography. J Urol [Internet]. Elsevier; 2010;183(2):603–7. Available from:  https://doi.org/10.1016/j.juro.2009.10.016.PubMedGoogle Scholar
  97. 97.
    Osman Y, El-Ghar MA, Mansour O, Refaie H, El-Diasty T. Magnetic resonance urethrography in comparison to retrograde urethrography in diagnosis of male urethral strictures: is it clinically relevant? Eur Urol. 2006;50(3):587–94.PubMedGoogle Scholar
  98. 98.
    Gupta N, Dubey D, Mandhani A, Srivastava A, Kapoor R, Kumar A. Urethral stricture assessment: a prospective study evaluating urethral ultrasonography and conventional radiological studies. BJU Int. 2006;98(1):149–53.Google Scholar
  99. 99.
    Buckley JC, Wu AK, McAninch JW. Impact of urethral ultrasonography on decision-making in anterior urethroplasty. BJU Int. 2012;109(3):438–42.PubMedPubMedCentralGoogle Scholar
  100. 100.
    Theisen KM, Kadow BT, Rusilko PJ. Three-dimensional imaging of urethral stricture disease and urethral pathology for operative planning. Curr Urol Rep [Internet]; 2016;17(8):1–7. Available from:  https://doi.org/10.1007/s11934-016-0616-0.
  101. 101.
    Chen L, Feng C, Lv XG, Fan HH, Joshi P, Barbagli G, et al. Three-dimensional computerized model based on the sonourethrogram: a novel technique to evaluate anterior urethral stricture. J Urol [Internet]. Elsevier. 2018;199(2):568–75. Available from:  https://doi.org/10.1016/j.juro.2017.08.098.Google Scholar
  102. 102.
    Sung DJ, Kim YH, Cho SB, Oh YW, Lee NJ, Kim JH, et al. Obliterative urethral stricture: MR urethrography versus conventional retrograde urethrography with voiding cystourethrography. Radiology [Internet]. 2006;240(3):842–848. Available from: http://pubs.rsna.org/doi/10.1148/radiol.2403050590.PubMedGoogle Scholar
  103. 103.
    Patil MB, Hannoun D, Reyblat P, Boyd SD. Total bladder and posterior urethral reconstruction: salvage technique for defunctionalized bladder with recalcitrant posterior urethral stenosis. J Urol [Internet]. Elsevier; 2015;193(5):1649–54. Available from:  https://doi.org/10.1016/j.juro.2014.11.102.PubMedGoogle Scholar
  104. 104.
    Dixon CM, Hricak H, McAninch JW. Magnetic resonance imaging of traumatic posterior urethral defects and pelvic crush injuries. J Urol [Internet]. 1992 [cited 2018 Oct 8];148(4):1162–1165. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1404629 PubMedGoogle Scholar
  105. 105.
    Koraitim MM, Reda IS. Role of magnetic resonance imaging in assessment of posterior urethral distraction defects. Urology. 2007;70(3):403–6.PubMedGoogle Scholar
  106. 106.
    Horiguchi A, Edo H, Soga S, Shinchi M, Masunaga A, Ito K, et al. Pubourethral stump angle measured on preoperative magnetic resonance imaging predicts Urethroplasty type for pelvic fracture urethral injury repair. Urology [Internet]. Elsevier; 2018;112:198–204. Available from:  https://doi.org/10.1016/j.urology.2017.09.038.PubMedPubMedCentralGoogle Scholar
  107. 107.
    El-Kassaby AW, Osman T, Abdel-Aal A, Sadek M, Nayef N. Dynamic three-dimensional spiral computed tomographic cysto-urethrography: a novel technique for evaluating post-traumatic posterior urethral defects. BJU Int. 2003;92(9):993–6.PubMedGoogle Scholar
  108. 108.
    Zhang XM, Hu WL, He HX, Lv J, Nie HB, Yao HQ, et al. Diagnosis of male posterior urethral stricture: comparison of 64-MDCT urethrography vs. standard urethrography. Abdom Imaging. 2011;36(6):771–5.PubMedGoogle Scholar
  109. 109.
    Chou C-P, Huang J-S, Yu C-C, Pan H-B, Huang F-D. Urethral diverticulum: diagnosis with virtual CT urethroscopy. AJR Am J Roentgenol [Internet]. 2005 [cited 2018 Oct 9];184(6):1889–1890. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15908547 PubMedGoogle Scholar
  110. 110.
    Feng C, Shen YL, Xu YM, Fu Q, Sa YL, Xie H, et al. CT virtual cystourethroscopy for complex urethral strictures: an investigative, descriptive study. Int Urol Nephrol. 2014;46(5):857–63.PubMedGoogle Scholar
  111. 111.
    Orabi H, Aboushwareb T, Tan J, Yoo JJ, Atala A. Can computed tomography – assisted virtual endoscopy be an innovative tool for detecting urethral tissue pathologies? Urology [Internet]. Elsevier; 2014;83(4):930–6. Available from:  https://doi.org/10.1016/j.urology.2013.11.014.PubMedGoogle Scholar
  112. 112.
    Song L, Xie M, Zhang Y, Xu Y. Imaging techniques for the diagnosis of male traumatic urethral strictures. J Xray Sci Technol. 2013;21(1):111–23.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Urology, Department of SurgeryUniversity of AlbertaEdmontonCanada
  2. 2.Urology Department, Division of Surgery, Faculty of MedicineP. Universidad Católica de ChileSantiagoChile
  3. 3.Urology ServiceDr. Sotero del Rio HospitalPuente AltoChile

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