European Radiology

, Volume 13, Issue 7, pp 1583–1596 | Cite as

Imaging of male urethra

Urogenital

Abstract.

The male urethral imaging and pathology is not widespread in the radiology literature because this part of the urinary tract is easily studied by urologists with clinical or endoscopic examinations. Ultrasonography and MR imaging are increasingly being used in association with voiding cystourethrography and retrograde urethrography. The posterior urethra is being studied with voiding cystourethrography or voiding sonography which allows the detection of bladder neck pathology, post-surgical stenosis, and neoplasms. The functional aspects of the bladder neck and posterior urethra can be monitored continuously in patients with neuromuscular dysfunction of the bladder. The anterior urethral anatomy and pathology is commonly explored by retrograde urethrography, but recently sonourethrography and MR imaging have been proposed, distending the lumen with simple saline solution instead of iodinated contrast media. They are being used to study the urethral mucosa and the periurethral spongy tissue which can be involved in the urethral pathologies such as strictures, diverticula, trauma, and tumors. Imaging has an important role to play in the study of the diseases of the male urethra since it can detect pathology not visible on urethroscopy. The new imaging techniques in this area, such as sonography and MR, can provide adjunct information that cannot be obtained with other modalities.

Keywords.

Male urethra Imaging Stenosis Neoplasm Trauma 

References

  1. 1.
    Friedland GW (1990) The urethra: imaging and intervention in the 1990s. Clin Radiol 42:157–160Google Scholar
  2. 2.
    Dunnick NR, Sandler CM, Amis ES et al. (1997) Textbook of uroradiology, 2nd edn. Williams & Wilkins, Baltimore, pp 465-485Google Scholar
  3. 3.
    Bates CP, Corney LE (1971) Synchronous cine/pressure/flow cystography: a method of routine urodynamic investigation. Br J Radiol 44:44–48Google Scholar
  4. 4.
    McCallum RW (1979) The adult male urethra: normal anatomy, pathology, and method of urethrography. Radiol Clin North Am 17:227–244Google Scholar
  5. 5.
    Gluck CD, Bundy AL, Fine C, Loughlin KR, Richie JP (1988) Sonographic urethrogram: comparison to roentgenographic techniques in 22 patients. J Urol 140:1404–1408Google Scholar
  6. 6.
    Shabsigh R, Fishman IJ, Krebs M (1987) The use of transrectal longitudinal real-time ultrasonography in urodynamics. J Urol 138:1416–1419Google Scholar
  7. 7.
    Perkash I, Friedland GW (1985) Real-time gray-scale transrectal linear array ultrasonography in urodynamic evaluation. Semin Urol 3:49–58Google Scholar
  8. 8.
    Chang SC, Yeh CH (1992) The applications of dynamic transrectal ultrasound in the lower urinary tract of men and women. Ultrasound Q 10:185–223Google Scholar
  9. 9.
    Nash PA, McAninch JW, Bruce JE, Hanks DK (1995) Sono-urethrography in the evaluation of anterior urethral strictures. J Urol 154:72–76Google Scholar
  10. 10.
    Bearcroft PWP, Berman LH (1994) Sonography in the evaluation of the male anterior urethra. Clin Radiol 49:621–626Google Scholar
  11. 11.
    Desser TS, Nino-Murcia M, Olcott EW, Rerris MK (1999) Advantages of performing sonourethrography with lidocaine hydrochloride jelly in a prepackaged delivery system. Am J Roentgenol 173:39–40Google Scholar
  12. 12.
    Nurenberg P, Zimmern PE (1997) Role of MR imaging with transrectal coil in the evaluation of complex urethral abnormalities. Am J Roentgenol 169:1335–1338Google Scholar
  13. 13.
    Duckett JW, Snow BW (1986) Disorders of the urethra and penis. Campbell's urology, 5th edn. Saunders, Philadelphia, pp 2000–2030Google Scholar
  14. 14.
    Friedland GW, Devries PA, Nino-Murcia M et al. (1990) Congenital anomalies of the urethra. In: Pollack HM (ed) Clinical urography. Saunders, Baltimore, pp 736–751Google Scholar
  15. 15.
    Blaivas JG, Norlen LJ (1984) Primary bladder neck obstruction. World J Urol 2:191–195Google Scholar
  16. 16.
    Fellows GJ, Cannell LB, Ravichandran G (1987) Transrectal ultrasonography compared with voiding cystourethrography after spinal cord injury. Br J Urol 59:218–221Google Scholar
  17. 17.
    Perkash I, Friedland GW (1986) Transrectal ultrasonography of the lower urinary tract: evaluation of bladder neck problems. Neurourol Urodyn 5:299–303Google Scholar
  18. 18.
    Callea A, Macchia R, Balacco G et al. (1997) Dynamic transrectal ultrasonography of the bladder neck. Arch Ital Urol 69:185–187Google Scholar
  19. 19.
    Shapeero LG, Friedland GW, Perkash I (1983) Transrectal sonographic voiding cystourethrography: studies in neuromuscular bladder dysfunction. Am J Roentgenol 14:83–90Google Scholar
  20. 20.
    Nishizawa O, Moriya I, Satoh S et al. (1982) A new video urodynamics: combined ultrasonotomographic and urodynamic monitoring. Neurourol Urodyn 1:295–299Google Scholar
  21. 21.
    Giudici L, Costato C, Ricci Babini V (1991) Transrectal echographic micturitional evaluation of bladder neck pathology. Arch Ital Urol 63:69–73Google Scholar
  22. 22.
    Sikafi Z, Butler MR, Lane V et al. (1985) Bladder neck contracture following prostatectomy. Br J Urol 57:308–310Google Scholar
  23. 23.
    Barbagli G, Azzaro F, Menchi I et al. (1995) Bacteriologic, histologic and ultrasonographic findings in strictures recurring after urethrotomy. Scand J Urol Nephrol 29:193–195Google Scholar
  24. 24.
    Askin B, Nilsson A, Pettersson S (1984) Functional evaluation of anterior urethral strictures with combined antegrade and retrograde urethrography. Scand J Urol Nephrol 18:1–7Google Scholar
  25. 25.
    Andersen J, Aagaard J, Jaszczak P (1987) Retrograde urethrography in the postoperative control of urethral strictures treated with visual internal urethrotomy. Urol Int 42:390–391Google Scholar
  26. 26.
    Merkle W, Wagner W (1988) Sonography of the distal male urethra: a new diagnostic procedure for urethral strictures – results of a retrospective study. J Urol 140:1409–1411Google Scholar
  27. 27.
    McAninch JW, Laing FC, Jeffrey RB (1988) Sonourethrography in the evaluation of urethral strictures: a preliminary report. J Urol 139:294–297Google Scholar
  28. 28.
    Merkle W, Wagner W (1990) Risk of recurrent stricture following internal urethrotomy: prospective ultrasound study of distal male urethra. Br J Urol 65:618–620Google Scholar
  29. 29.
    Gupta S, Majumdar B, Tiwari A et al. (1993) Sonourethrography in the evaluation of anterior urethral strictures: correlation with radiographic urethrography. J Clin Ultrasound 21:231–239Google Scholar
  30. 30.
    Das S (1992) Ultrasonographic evaluation of urethrae stricture disease. Urology 40:237–242Google Scholar
  31. 31.
    Chiou RK, Anderson JC, Tran T, Patterson RH, Wobig R, Taylor RJ (1996) Evaluation of urethral strictures and associated abnormalities using high-resolution and color Doppler ultrasound. Urology 47:102–107Google Scholar
  32. 32.
    Derschum W, Dittrich A, Vandendris M, Vietsch H von (1996) Echography in the diagnosis of strictures of the anterior male urethra. J Urol 155:426A (abstract 464)Google Scholar
  33. 33.
    Morey AF, McAninch JW (1997) Role of preoperative sonourethrography in bulbar urethral reconstruction. J Urol 158:1376–1379Google Scholar
  34. 34.
    Pavlica P, Menchi I, Barozzi L (in press) New imaging of the anterior male urethra. Abdom ImagingGoogle Scholar
  35. 35.
    Hoebeke PB, Van Laecke E, Raes A et al. (1997) Membrano-bulbo-urethral junction stenosis. Eur Urol 32:480–484Google Scholar
  36. 36.
    Perkash I, Friedland GW (1987) Ultrasonographic demonstration of false passage arising from the posterior urethra in spinal cord injury patients. J Urol 137:701–702Google Scholar
  37. 37.
    Maizels M, Stephens FD, King LR et al. (1983) Cowper's syringocele: a classification of dilatations of Cowper's gland duct based on clinical characteristics of 8 boys. J Urol 129:111–114Google Scholar
  38. 38.
    Brock WA, Kaplan GN (1979) Lesions of Cowper's glands in children. J Urol 122:121–123Google Scholar
  39. 39.
    Merchant SA, Amonkar PP, Patil JA (1997) Imperforate syringoceles of the bulbourethral duct: appearance on urethrography, sonography and CT. Am J Roentgenol 169:823–824Google Scholar
  40. 40.
    Khati NJ, Javitt MC, Schwartz AM, Berger BM (1998) Resident's teaching files: MR imaging diagnosis of a urethral diverticulum. Radiographics 18:517–532Google Scholar
  41. 41.
    Sandler CM, McCallum RW (1990) Injuries of the urethra. In: Pollack HM (ed) Clinical urography. Saunders, Baltimore, pp 1522–1534Google Scholar
  42. 42.
    Porter JR, Takayama TK, Defalco AJ (1997) Traumatic posterior urethral injury and early realignment using magnetic urethral catheters. Radiology 205:589Google Scholar
  43. 43.
    Narumy Y, Hricak H, Armenakas NA et al. (1993) MR imaging of traumatic posterior urethral injury. Radiology 188:439–443Google Scholar
  44. 44.
    McCallum RW(1990) Urethral neoplasms. In: Pollack HM (ed) Clinical urography. Saunders, Baltimore, pp 1404–1413Google Scholar
  45. 45.
    Bissada NK, Cole AT, Fried FA (1974) Extensive condylomas acuminata of the entire male urethra and the bladder. J Urol 112:201–203Google Scholar
  46. 46.
    Vapnek JM, Hricak H, Carrol PR (1992) Recent advances in imaging studies for staging of penile and urethral carcinoma. Urol Clin North Am 19:257–266Google Scholar

Copyright information

© Springer-Verlag  2003

Authors and Affiliations

  1. 1.Department of Diagnostic Radiology, Hospital M. Malpighi, Via Palagi 9, 40138 Bologna, ItalyItaly
  2. 2.Department of Emergency Radiology, Hospital S. Orsola-Malpighi, 40138 Bologna, ItalyItaly
  3. 3.Department of Diagnostic Radiology, Hospital S. Maria Nuova, 55100 Florence, ItalyItaly

Personalised recommendations