The Role of Sonourethrography In the Evaluation of Anterior Urethral Strictures: A Correlation with Retrograde Urethrography

Objective: Retrograde urethrography (RGU) is the most commonly used imaging modality for the evaluation of the anterior urethra. Sonourethrography (SUG) is another modality that is not so frequently used, though several studies have suggested its higher degree of sensitivity and specificity in anterior urethral stricture evaluation. The present prospective study has been done to compare the results of SUG with that of RGU and to probe its effect in decision making. Patients and Methods: A total of 50 patients with anterior urethral stricture disease were evaluated with both SUG and RGU for stricture length, site location, and associated urethral pathologies. Collected information was used as a guide for the choice of surgery, and it was compared with operative findings. Results: The mean lengths of strictures on SUG, RGU, and surgery were 20.46 cm, 17.14 cm, and 20.35 cm, respectively. Overall sensitivity and accuracy of SUG in predicting correct stricture length was 95.55 and 97.33%, respectively, and overall sensitivity and accuracy of RGU in predicting correct stricture length was 77.22 and 85.33%, respectively. Spongiofibrosis was noted only with SUG in 78 to 88% accuracy. In 32% of cases, the surgical plan changed when SUG results were taken into consideration along with RGU. Conclusion: SUG is more accurate in measuring stricture length, especially that of the bulbar urethra. It simultaneously provides a better assessment of a diseased urethra. It should be used as an extension of the physical examination by the treating urologist as it helps in better preoperative surgical planning of anterior urethral strictures.