Sonographic staging of anterior urethral strictures

Purpose: Although radiographic retrograde urethrography has traditionally been the gold standard for imaging the anterior urethra, sonourethrography has proved to be precise and effective for evaluating urethral strictures. We review the evolution of sonourethrography and demonstrate its practical contemporary applications. Materials and Methods: We performed literature reviews on MEDLINE and chart reviews of our patient records from 1988 to 1998. Results: Sonourethrography measures stricture length in the bulbar urethra more accurately than conventional retrograde urethrography. Spongiofibrosis is manifested sonographically by a lack of urethral distensibility during retrograde instillation of saline solution. Posterior shadowing is noted in severe posttraumatic cases. Sonographic staging before treatment of complex or reoperative anterior strictures elucidates complicating features, such as calculi, urethral hair, false passage and stent encrustation. Conclusions: Sonographic staging of anterior urethral strictures offers clinically important information that may be useful in guiding reconstructive therapy.