Sonographic staging of anterior urethral strictures

Purpose: Although radiographic retrograde urethrography has traditionally b een the gold standard for imaging the anterior urethra, sonourethrography h as proved to be precise and effective for evaluating urethral strictures. W e review the evolution of sonourethrography and demonstrate its practical c ontemporary 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 comple x 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 cli nically important information that may be useful in guiding reconstructive therapy.