CU 43. Comparison of 64 - MDCT urethrography versus standard urethrography in diagnosis of male posterior urethral stricture (report of 21 cases)

Purpose: To compare the clinical relevance of conventional voiding/retrograde urethrography and multiple detector computerized tomography (64-MDCT) urethrography for the evaluation of male posterior urethral stricture.

Methods: From January to October 2009, 21 men were referred to our institution for the management of posterior urethral stricture. The patients were evaluated with conventional voiding and retrograde urethrography and multiple detector computerized tomography urethrography. The patients were examined by open operative intervention which was required in all patients. The radiologic data were compared using the operative findings.

Results: Although the overall diagnostic accuracy for urethral stricture was equal for both modalities (100%), computerized tomography urethrography provided extra clinical data in 10 patients. It was superior to conventional urethrography for judging the urethral stricture length in 3 patients, characterizing the site of urethra-rectal fistula in 4 patients, and accurately delineating the proximal urethra in 6 patients.

Conclusions: Computerized tomography urethrography is a promising tool as an alternative to traditional radiographic methods for defining male urethral strictures. Computerized tomography urethrography has the advantage of examining patients only in one position, without distortion, and by generating three-dimensional images, it can accurately measure the stricture length, aid in the diagnosis of some associated pathological conditions, such as urethro-rectal fistula, and does not expose the physician to radiation. CTU are recommended for those patients with complex posterior urethral stricture who underwent CU but have questionable results.