MRI of female urethra and periurethral pathologies

Itani, Malak; Kielar, Ania Z.; Menias, Christine O.; Dighe, Manjiri; Surabhi, Venkateswar R.; Prasad, Srinivasa R.; O’Malley, Ryan B.; Gangadhar, Kiran; Lalwani, Neeraj

doi:10.1007/s00192-015-2790-x

Cited by 33 publications

(23 citation statements)

References 32 publications

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“…Periurethral glands are located in the posterolateral aspect of the distal two-thirds of the urethra. The location of the most urethral diverticula corresponds to the location of the periurethral glands, further supporting the theory of formation of diverticula in patients with infected and obstructed periurethral glands (44).…”

Section: Urethral Diverticulumsupporting

confidence: 72%

“…Skene Gland Cysts.-Skene gland cysts are cysts of Skene (periurethral) ducts, which are tubuloalveolar structures located in the posterolateral aspect of the distal two-thirds of the urethra. The largest and most caudally located periurethral glands are called Skene glands (44). The glands secrete mucus and have ducts that drain directly into the urethral lumen.…”

Section: Urethral Diverticulummentioning

confidence: 99%

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Imaging of Acute Conditions of the Perineum

et al. 2018

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A wide range of acute conditions can affect the perineum, from self-limited disease to conditions that are potentially life threatening or contribute to substantial patient morbidity if not promptly diagnosed and appropriately treated. Imaging is essential in the clinical management of perineal disease because it allows accurate anatomic localization of the origin and extent of the disease to be determined. Familiarity with complex perineal anatomy, appropriate use of imaging modalities, and the spectrum of imaging findings seen in acute perineal conditions is crucial for radiologists to make a rapid and accurate diagnosis. Various imaging modalities are available to evaluate acute perineal conditions, each with their own advantages and disadvantages. Computed tomography is used most commonly in the acute care setting because of its widespread availability and rapid image acquisition. Ultrasonography could be used to evaluate superficial and palpable abnormalities and is especially helpful for diagnosis of genital injuries. Magnetic resonance (MR) imaging exhibits superior tissue contrast resolution, provides excellent characterization of conditions, and lacks ionizing radiation. Its role is increasing in the acute care setting; however, MR imaging is not always readily available and is currently reserved for use as a problem-solving technique. Retrograde urethrography is the modality of choice for evaluating traumatic urethral injury. RSNA, 2018.

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Section: Urethral Diverticulumsupporting

confidence: 72%

Section: Urethral Diverticulummentioning

confidence: 99%

Imaging of Acute Conditions of the Perineum

et al. 2018

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“…Unenhanced T1-weighted and T2-weighted MRI images were obtained. A suburethral mass was diagnosed if a mass lesion was present and located posterolateral to the urethra 14 . The two perpendicular diameters of the mass were measured in mm in the axial and sagittal planes, and the largest diameter of the mass was used in the analysis.…”

Section: Methodsmentioning

confidence: 99%

Transperineal and endovaginal ultrasound for evaluating suburethral masses: comparison with magnetic resonance imaging

Okeahialam

Taithongchai

Sultan

et al. 2021

Ultrasound in Obstet & Gyne

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The agreement between pelvic floor ultrasound (US) and magnetic resonance imaging (MRI) for detecting a suburethral mass was 85%. MRI had good-to-excellent agreement with both two-dimensional transperineal US and three-dimensional endovaginal US for the measurement of the distance between the suburethral mass and the bladder neck and the largest diameter of the mass. What are the clinical implications of this work?Pelvic floor US could become an important imaging modality for the diagnosis and assessment of suburethral masses, and for surgical planning and counseling of patients.

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“…In contrast, Gakis et al [30] reported one case (0.9%) of secondary bladder cancer 41 mo after initial therapy for PUC. Enlarged regional lymph nodes (LNs) are likely to represent metastatic disease (84%), making assessment of disease extent with pelvic magnetic resonance imaging for local staging obligatory [13,31,32]. Additionally, LN biopsy is proposed by the NCCN as well.…”

Section: Diagnostic Evaluation and Stagingmentioning

confidence: 99%

Current Disease Management of Primary Urethral Carcinoma

Janisch

Abufaraj

Fajković

et al. 2019

European Urology Focus

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Context: Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making evidencebased management recommendations difficult. Objective: To review reported disease management strategies of PUC and their impact on oncological outcomes. Evidence acquisition: A systematic research was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement using Medline, Scopus, and Web of Science, to find studies of the past 10 yr including !20 patients, and investigating treatment strategies and their impact on outcomes of the three most frequent histologies: urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma. Evidence synthesis: In localized PUC, penis-sparing surgery can be performed in males, while in females, complete urethrectomy with surrounding tissue is advised to minimize recurrence due to positive margins. Radiotherapy (RT) has worse survival and recurrence rates, as well as more adverse effects, than surgery, limiting its use in genital-preserving therapy. Locally advanced PUC should be treated with multimodal therapy, as monotherapies result in inferior recurrence and survival rates. Extent of surgery is still undecided, favoring radical cyst (oprostat)ectomy with total urethrectomy (RCU). Lymph node involvement is a predictor of survival, highlighting the role of lymph node dissection for disease control and staging. RT can improve survival in combination with surgery and/or chemotherapy (CHT). Neoadjuvant platinum-based CHT can improve overall and recurrence-free survival. At recurrence, salvage therapy with surgery and/or CHT can improve survival. Superficial urothelial carcinoma of the prostatic urethra can be treated with transurethral resection. Stromal invasion often features concomitant bladder cancer with a poor prognosis and requires RCU with or without systemic preoperative CHT. Conclusions: PUC is a rare malignancy with an often poor natural course, requiring a stageand gender-specific risk-based treatment strategy. The role of systematic perioperative CHT and the extent of surgery are becoming more important. Patient summary: In this review, we looked at the treatment options for primary urethral cancer. We found that while an organ-confined disease can be managed with local resection, growth beyond the organ border makes a combination of different treatment modalities, such as surgery and systematic chemotherapy, necessary to improve outcomes.

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MRI of female urethra and periurethral pathologies

Abstract: We provide a comprehensive review of normal MR anatomy of the female urethra, as well as the MR features of practically important urethral and periurethral lesions.

Cited by 33 publications

References 32 publications

Imaging of Acute Conditions of the Perineum

Imaging of Acute Conditions of the Perineum

Transperineal and endovaginal ultrasound for evaluating suburethral masses: comparison with magnetic resonance imaging

Current Disease Management of Primary Urethral Carcinoma

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