Diagnostic Accuracy of Sonourethrography in Anterior Uretheral Strictures Taking Surgical Findings as Gold Standard

Abstract

Objective: To compare the utility of sonouretherography (SUG) in conjunction with luoroscopic guided uretherography in determination of uretheral strictures taking surgical indings as gold standard.

Methods: This cross-sectional study was conducted at department of Radiology, Liaquat National Hospital, Karachi from May to October 2016. All male patients having lower urinary tract symptoms (thin
streak of micturation or interrupted micturation) for 1 week or longer were included. Probe with high frequency was used for evaluation of strictures by SUG. Procedure was done by introduction of normal
saline via Foley's catheter with its bulb inlated in navicular fossa. Anterior urethra was visualized up to the penoscrotal junction with multiple longitudinal and transverse scans by placing the transducer on the
ventral surface of penis. The indings of SUG were compared with retrograde uretherogram and surgical indings when stricture was preoperatively detected.

 Results: Out of total 145 patients, the average age of the patients was 37.22±11.09 years. SUG indings showed true positive cases in 31 (21.37%) patients whereas 98 (67.58%) patients were true negative. The sensitivity, specificity, PPV and NPV and accuracy of SUG for detection of anterior urethral stricture was 81.6%, 91.6%%, 77.5%, 93.3% and 88.9% respectively. Postsurgical conirmation of anterior urethral stricture was 26.2% while SUG was diagnosed in 27.6% cases

Conclusion: SUG can be used as an alternative to conventional luoroscopic guided uretherography in evaluation and categorization of strictures in urethra, their grading and is the procedure without ionization radiation.