ASSESSMENT OF THE ROLE OF SONOURETHROGRAPHY IN EVALUATION OF ANTERIOR URETHRAL STRICTURES

Objective: To assess the role of sonourethrography as a dynamic method of staging urethral strictures that delineates the appropriate length of strictures as well as the severity of periurethral scarring; and utility of this in deciding which type of surgical management is best for the pathologic process. Patients and Methods: Forty -eight male patients having anterior urethral strictures less than 2.5cm. in length as assessed by conventional radiographic . urethrogram RUG ; were re-evaluated by sonourethrography (SUG) before undergoing visual internal urethrotomy V.I.U. The appropriate length of the urethral stricture as compared to endoscopic findings, the extent of the spongiofibrosis and the anatomy of the peri-urethral structures are assessed by sonographic urethrogram to delineate which cases respond well to V.I.U.; and those best managed by open urethroplasty. Results: The stricture lengths measured endoscopically during V.I.U. using 4 Fr. ureteric catheters, correlated better with sonographic lengths than with lengths detected by radiography. Underestimation of stricture length by RUG was especially evident in bulbar urethral strictures. On follow up the rate and duration to recurrence were found to be related to the presence as well as the degree of spongiofibrosis. Conclusion: Sonourethrography is a simple and effective technique for evaluation of male anterior urethra. It provides accurate information about stricture length, degree of spongiofibrosis and periurethral pathologies so it can be considered a useful tool when determining the type of operative procedure suitable for strictures localized to anterior urethra.