SONOURETHROGRAPHY&RETROGRADE URETHROGRAPHY FINDINGS OF PATIENTS SUSPECTED TO HAVE URETHRAL STRICTURES AT SPHMMC, ADDIS ABABA, ETHIOPIA

Abstract

Abstract Background; Urethral strictures are abnormal narrowing’s of the urethra resulting from fibrous scar tissue. They may involve the entire urethra or only a small portion. Abrupt, short-segment strictures are usually traumatic. Long-segment strictures may be either traumatic or inflammatory Stricture urethra in Males is a common problem encountered by the urologists. Besides history and physical examination, ascending urethrogram remained the Gold Standard for evaluating male urethral stricture. It has a Sensitivity of 91% and specificity of 72% for diagnosing anterior urethral strictures. Sonourethrography (SUG) is better than retrograde urethrography(RUG) as it gives a more accurate estimate of stricture length and periurethral pathology along with additional information about periurethral fibrosis. It also has an advantage of no exposure to radiation. Objective; The objective of this study was to compare the efficacy of Sono-urethrogram with Ascending urethrogram in the evaluation of Male anterior urethral strictures. Methods ;This study was conducted in the department of radiology, St. paulhospital, Addis Ababa, between march 1, 2017 to June 30 2017. All Male Patients presenting with obstructing voiding symptoms suggestive of stricture urethra were selected. Data was compiled and analyzed using the computer software (SPSS version 21 )and presented using numbers odds ratio and tables. comparison was made between sonourethrography and RUG.. RESULT ; In our study total of 41 patients underwent the study out of whom ten patients are found to be normal Remaining 30 patients had findings of varying type on both modalities. Out of these 30 patients, 28 patients had stricture and two patients without stricture. Bulbar urethral strictures were the commonest found in 17 patients with both the modalities.. Total seven penile strictures were diagnosed on both the modalities. One membranous urethra stricture was not visualized on SUG. Out of 28 patients, 20 patients had short segment strictures, 4 patients had long segment strictures and 4 patients had complex strictures. Out of the 20 short segment strictures, 16 were bulbar (Figure 4) while 4 were penile short segment strictures. In long segment strictures total four patients were identified, three penile (Figure 5) and one was bulbar. Out of 28 patients with diagnosis of urethral stricture diseases, sonourethrography revealed periurethral fibrosis in 14 (50 %) patients Discussion and conclusion Characterization of urethral stricture based on location multiplicity and length matched well on both modalities but in diagnosing other periurethral pathologies SUG showed upper hand.this finding correlate well with previous similar studies. In the present study, we have found sonourethrography to be a multiplanner, easily available and cost effective technique for evaluating the male anterior urethra without radiation exposure. When compared with conventional RGU, sonourethrography is equally effi cacious in detecting anterior urethral stricture diseases.