Magnetic Resonance Urethrography in Comparison to Retrograde Urethrography in Diagnosis of Male Urethral Strictures: Is It Clinically Relevant?

Published:January 23, 2006DOI:



      To compare the clinical relevance of retrograde urethrography (RUG) and magnetic resonance (MR) urethrography in evaluating male urethral strictures.


      Between January and April 2004, 20 men were referred to our institute for management of urethral strictures. The patients were investigated by conventional RUG and multiformat MR urethrography. The patients were examined by urethroscopy under anesthesia to be followed by definitive endoscopic or open operative intervention. The radiologic data were compared by endoscopic as well as operative findings in all the patients.


      Ten patients were managed by visual internal urethrotomy (VIU) and two by dilatation under anesthesia; two showed normal urethral caliber. Four patients required open urethral reconstructive procedures. Two patients underwent radical cystectomy and cutaneous diversion because of associated bladder or urethral malignancy. Although overall accuracy for diagnosis of urethral strictures was equal between both modalities (85%), MR urethrography provided extra clinical data in seven patients (35%). It was superior to RUG in judging the urethral stricture length in three patients, diagnosing a urethral tumor in one, detecting associated bladder mass in one, characterizing the site of urethra-rectal fistula in one, and accurately delineating the proximal urethra in the last patient. Unlike RUG, MR urethrography provided adequate information about the degree of spongiofibrosis in all patients.


      MR urethrography is a promising tool for defining male urethral strictures and can provide extra guidance for treatment planning that cannot be obtained with RUG.


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        • Heidenreich A.
        • Derschum W.
        • Bonfig R.
        • Wilbert D.
        Ultrasound in the evaluation of urethral stricture disease: a prospective study in 175 patients.
        Br J Urol. 1994; 74: 93-98
        • Ryu J.
        • Kim B.
        MR imaging of the male and female urethra.
        Radiographics. 2001; 21: 1169-1185
        • Pavlica P.
        • Menchi I.
        • Barozzi L.
        New imaging of the anterior male urethra.
        Abdom Imaging. 2003; 28: 180-186
        • Gupta S.
        • Majumdar B.
        • Tiwari A.
        • Gupta R.
        • Kumar A.
        • Gujral R.
        Sonourethrography in the evaluation of anterior urethral strictures: correlation with radiographic urethrography.
        J Clin Ultrasound. 1993; 21: 231-239
        • Babnik Peskar D.
        • Visnar Perovic A.
        Comparison of radiographic and sonographic urethrography for assessing urethral strictures.
        Eur Radiol. 2004; 14: 137-144
        • Gallentine M.
        • Morey A.
        Imaging of the male urethra for stricture disease.
        Urol Clin North Am. 2002; 29: 361-372
        • Cunningham J.
        The diagnosis of stricture of the urethra by Roentgen rays.
        Trans Am Assoc Genitourin Surg. 1910; 5: 369-371
        • Rosen M.
        • McAninch J.
        Preoperative staging of the anterior urethral stricture.
        in: McAninch J.W. Traumatic reconstructive urology. Saunders, Philadelphia1996: 551-564
        • Mullin E.
        • Peterson L.
        • Paulson D.
        Retrograde urethrogram: diagnostic aid and hazard.
        J Urol. 1973; 110: 464-466
        • Skati D.
        Ultrasonographic evaluation of the urethral stricture disease.
        Urology. 1992; 40: 237-242
        • Beckert R.
        • Gilbert P.
        • Kreutzig T.
        Spongiosography: a valuable adjunct to the diagnosis of urethral strictures.
        J Urol. 1991; 146: 993-996
        • Morey A.
        • McAninch J.
        Ultrasound evaluation of the male urethra for assessment of urethral stricture.
        J Clin Ultrasound. 1996; 24: 473-479
        • Schulam P.
        • Kawashima A.
        • Sandler C.
        • Barron B.
        • Lamki L.
        • Goldman S.
        Urinary tract imaging: basic principles.
        in: Walsh P. Retik A. Campbell’s urology. 8th ed. Saunders, Philadelphia2002: 122-167
        • McAninch J.
        • Laing F.
        • Jeffrey Jr., B.
        Sonourethrography in the evaluation of urethral strictures: a preliminary report.
        J Urol. 1988; 139: 294-297
        • Narumi Y.
        • Hricak H.
        • Armenakas N.
        • Dixon C.
        • McAninch J.
        MR imaging of traumatic posterior urethral injury.
        Radiology. 1993; 188: 439-443
        • El-Diasty T.
        • El-Ghar M.
        • Shokeir A.
        • et al.
        Magnetic resonance imaging as a sole method for the morphological and functional evaluation of live kidney donors.
        BJU Int. 2005; 96: 111-116
        • Devine C.
        • Jordan G.
        • Schlossberg S.
        • Vaughan Jr., E.
        Surgery of the penis and urethra.
        in: Walsh P. Retik A. Campbell’s urology. 8th ed. Saunders, Philadelphia2002: 3886-3954
        • Jordan G.
        • Devine P.
        Management of urethral stricture disease.
        Clin Plast Surg. 1988; 15: 493-505
        • Semelka R.
        • Hricak H.
        • Kim B.
        • et al.
        Pelvic fistulas: appearance on MR images.
        Abdom Imaging. 1997; 22: 91-95
        • Dixon C.
        • Hricak H.
        • McAninch J.
        Magnetic resonance imaging of traumatic posterior urethral defects and pelvic crush injuries.
        J Urol. 1992; 148: 1162-1165