Role of MRUrethrography Compared to Conventional Opposing Urethrographyin the Surgical Management of ObliterativePosterior Urethral Stricture
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 2
Abstract
Objective: To prospectively assess the role of MR urethrography compared to conventional opposing urethrography in the surgical management of obliterativeposterior urethral stricture. Materials And Methods: 18 male patients along with 2 controls in the age group of 20-65, who presented to the radiology department with symptoms of urinary retention and in whom conventional opposing urethrography (OUG) had been performed were taken up for study.MR urethrography (MRU)was performed in these patients after a time interval of about 4 to 10 days, were analysed and it was focussed on location, number, length and the signal intensity of the stricture. Urethral stricture is measured along the long axis of the fibrotic segment shown as low signal intensity on the sagittal T2-weighted images. Posterior urethral stricture is determined to be the distance between the proximal limit of the distal distended urethra and the prostatic apex on the sagittal T2-weighted images. Stricture length onOUG was determined by measuring the distance between the proximal end of the distal distended urethra and the distal end of the open proximal urethra.Strictures with length of < 2.5 were defined as “short strictures”, where as those > 2.5 as “long strictures”. Additionally, MR findings were evaluated with regard to the urethra proximal to the stricture, the corpora spongiosa surrounding the stricture, adjacent organ injuries, and the associated complications like prostatic apex displacement, fistulas, sinus tracts etc., Results And Analysis: Paired T test correlations was performed to correlate the imaging and surgical length of stricture. The mean measurement errors between the imaging and surgical values of stricture length were calculated in each imaging method.MRU proved to be 100% sensitive and specific comparedto opposing urethrographywith a sensitivity and specificity of 22%, 70% for posterior urethral strictures. Conclusion: MR Urethrography using T2 weighted sequences can be a valuable means of imaging patients with posterior urethral strictures as well as rest of urinary system.From our study, it is evident that MRU depicts stricture length, periurethral fibrosis, displacement of the prostatic apex and also associated pathologies with accuracy, there by assisting the surgeons to the select most appropriate surgical procedure for the patients with obliterative urethral stricture.
Authors and Affiliations
Dr. V. Sudhakar, Dr. S. Senthil Kumar
Keywords
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- EP ID EP592308
- DOI 10.9790/0853-1602064653.
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