SONOURETHROGRAPHIC ASSESSMENT OF URETHRAL OBSTRUCTION

CORRESPONDING AUTHOR:
Dr. Narendra G. Tembhekar,
Abhiyanta Colony,
Ganeshpur, Bhandara (M. S.),
Maharashtra, India.
Email: shalinitembhekar@gmail.com

ABSTRACT: BACKGROUND: Previously retrograde urethrography and micturating cystoure-thrography were used for the evaluation of urethral strictures. Lack of radiation, ability to assess of mucosal and periurethral abnormality and more precise measurement of stricture length makes the sonourethrography an alternative to conventional urethrography. In this article we had reported our experience regarding sonourethrography in cases of anterior urethral strictures. OBJECTIVES: Role of sonourethrography in evaluation of anterior urethral abnormalities (especially strictures), Staging and grading of anterior urethral strictures. To compare the utility of sonourethrography as compared to conventional retrograde urography. Role of sonourethrography in diagnosis, management and follow-up of anterior urethral disorders (especially strictures). MATERIAL AND METHOD: 70 male patients with obstructive urinary symptoms reffered from urology department for retrograde urethrography were selected. Sonourethrographic studies were performed using high frequency probe while injecting saline solution through 12 F Foley’s catheter with bulb inflated in the fossa navicularis. Findings were compared with retrograde urethrography and urethroscopy. RESULT: Out of total 70 patients who underwent sonourethrogram, 33 patients were diagnosed to have 39 strictures. Out of these 39 strictures, 2 strictures were mild (5.12%), 16 were moderate (41.02%) and 21 were severe (53.84%). 20 strictures were short (focal) while 13 were long (diffuse). One patient had 3 large urethral calculi within the urethral lumen area which were visualised on sonourethrogram. These 39 strictures were also classified under five grade classification proposed by Chiou et al. Of these 39 strictures, 2 classified as GRADE I (5.12%), 6 classified as GRADE II (15.38%), 11 classified as GRADE III (28.20%), 4 classified as GRADE IV (10.25%), 16 came under GRADE V (41.02%). CONCLUSION: Sonourethrography can be used as an alternative to retrograde urethrography in the diagnosis of urethral disorder, characterization of urethral strictures and assessing the amount of fibrosis for better management.

KEYWORDS: Sonourethrography, Retrograde Urethrography, Urethral Strictures.