The application of CT voiding urethrography in the evaluation of urethral stricture associated with fistula: a preliminary report

To date, urethral stricture disease in men, though relatively common, represents an often poorly managed condition. Therefore, this article is dedicated to encompassing the currently existing data upon anatomy, etiology, symptoms, diagnosis, and treatment of the disease, based on more than 40 years of experience at a tertiary referral center and a PubMed literature review enclosing publications until September 2018.

show abstract

“…A CT voiding urethrography can provide useful information in case of stricture related fistulas [18].…”

Section: Symptoms and Diagnosismentioning

confidence: 99%

A Comprehensive Review Emphasizing Anatomy, Etiology, Diagnosis, and Treatment of Male Urethral Stricture Disease

Verla

Oosterlinck

Spinoit

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Some studies report the usefulness of CT-VCUG for evaluating the bladder and posterior urethra [5,9,10]. Chou et al [9] in a study of 13 males with traumatic antecedents reported the diagnostic potential of 3D CT-VCUG after intravenous (i.v.)…”

Section: Discussionmentioning

confidence: 99%

“…Su et al [10] described 3D and 4D CT-VCUG after i.v. the contrast in 70 healthy subjects (43 males and 27 females) using 640-slice dynamic volume CT. Two studies using CT-VCUG [5,9] took a mean time of 8.8 and 9 min (range, 4-20 min) and another performing combined retrograde and voiding CT [11] took a mean time of 10 min (range, 6-20 min). The mean time for CT-RUG in our study was 6.1 min (range, 4.7-7.7 min) and it must be remembered that a lot of this time was spent by the nurse performing the clamp method because the CT technique and cystourethral filling with contrast were quick.…”

Section: Discussionmentioning

confidence: 99%

“…Detection of an anterior urethral stricture on RUG is an indication for retrograde sonourethrography (RSUG), as it gives a more accurate measurement and visualizes the surrounding spongiofibrosis, which is fundamental for planning treatment [1][2][3]. Computed-tomography urethrography (CT-UG) is rarely used and its usefulness is limited to the evaluation of traumatic urethral injuries and periurethral fistulas [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A New Technique for Computed-Tomography Urethrography in Males: The Clamp Method

et al. 2021

View full text Add to dashboard Cite

The aim of the present study is to describe and evaluate a new technique for performing Computed-Tomography Retrograde Urethrography (CT-RUG). Males with urethral anomalies detected by retrograde urethrography (RUG) and/or retrograde sonourethrography (RSUG) underwent CT-RUG using the clamp method and three radiologists evaluated the anomalies in each technique separately and blindly. CT-RUG was done successfully in all the cases (n = 22), with means of 6 min duration and 95 mL of contrast; no pain was reported by 81% of the patients (VAS: 0) and very mild pain by the rest (VAS: 0.5–1.2). CT-RUG showed better diagnostic efficacy in cases of periurethral fistula (n = 8), urethral stent (n = 3), previous urethroplasty and urethral lithiasis (n = 2), a similar accuracy to RSUG for measuring the length of anterior urethral strictures (n = 9) and greater accuracy than RUG (p = 0.008). Six cases received 2 CT sweeps, with an effective dose of 4.96 mSv, and the remaining 16 had 1 sweep and received 3.456 mSv. To the best of our knowledge, this is the first study to describe the clamp method for CT-RUG, a method that is effective and comfortable for both the patient and the operator (retrograde infusion of contrast).

show abstract

“…In the urinary bladder and proximal urethra, such structural defects recognizable using a combination of retrograde urethrogram and voiding cysto-urethrogram include irregular inner bladder margin suggestive of thickened urinary bladder wall (detrusor hypertrophy) with implication similar to that of observing trabeculation and sacculation at cystoscopy [8], dilated proximal urethral segment and overdistended urinary bladder with significant postvoid residual urine volume [6]. Others include urinary bladder diverticulum of any size which could be solitary or multiple, vesico-ureteric reflux of any grade which could be unilateral or bilateral, and urethrocutaneous fistula of any course which could be solitary or multiple (watering-can perineum) [2, 9]. All of these are demonstrable with a combination of retrograde urethrogram and voiding cysto-urethrogram.…”

Section: Introductionmentioning

confidence: 99%

Comparing complications of urethral stricture across various ages: a retrospective analysis of findings from retrograde urethrogram and voiding cysto-urethrogram over 10 years

et al. 2019

View full text Add to dashboard Cite

ObjectiveTo determine the rate and the distribution of the structural defects in the urinary bladder complicating urethral stricture in men, and to compare the complications observed in the younger patients to those observed in the older patients.MethodsRetrospectively, case files of patients diagnosed of urethral stricture using retrograde urethrogram (RUG) and voiding cysto-urethrogram (VCUG) from February 2009 to August 2018 were analyzed. Stricture characteristics were outlined. In addition, complicating structural defects in the lower urinary tract proximal to the stricture site were documented. The complicating defects identified in the patients were segregated according to age for any observable associations. Logistic regression analysis was used to define the nature of the association of patient age, stricture site, number and length, with distribution of complicating structural defects. Analyses were done using SPSS® version 20.ResultsWithin the 10-year review period, 257 of 421 suspected cases of urethral stricture were confirmed. Patients are between 1 and 104 years of age (mean: 50.1 ± 19.1 years; median: 51.0 years IQR 35.0–65.0). Bulbar (34.2%); short segment (62.6%); partial (73.9%) strictures are prevalent. Forty-seven (18.3%) of 257 patients presented with 1 or more complications. Bladder diverticulum (8.6%) and urethra-cutaneous fistula (6.6%) are prevalent complications. The distribution of complications does not vary with age, or with stricture characteristics.ConclusionPresentation with complications is not uncommon. The distribution of these complications does not vary with age or with stricture characteristics.

show abstract

The application of CT voiding urethrography in the evaluation of urethral stricture associated with fistula: a preliminary report

Abstract: CT voiding urethrography is a useful technique for the diagnosis of urethral disease, especially in male patients suffering from urethral stricture associated with fistula.

Cited by 12 publications

References 11 publications

A Comprehensive Review Emphasizing Anatomy, Etiology, Diagnosis, and Treatment of Male Urethral Stricture Disease

A Comprehensive Review Emphasizing Anatomy, Etiology, Diagnosis, and Treatment of Male Urethral Stricture Disease

A New Technique for Computed-Tomography Urethrography in Males: The Clamp Method

Comparing complications of urethral stricture across various ages: a retrospective analysis of findings from retrograde urethrogram and voiding cysto-urethrogram over 10 years

Contact Info

Product

Resources

About