Ramírez-Sandoval NP, Pacheco-Gambler C, Ochoa-García A

Language: Spanish
References: 9
Page: 14-21
PDF size: 632.40 Kb.

ABSTRACT

Objetive: evaluate the frequency and morphological characteristics of spongiofibrosis in patients with diagnosis of anterior urethral stricture using sonourethrography as a complementary method, performed in the imaging service.
Material and Method: a transverse, observational and descriptive study of patients admitted to the outpatient unit of the urology service at Hospital General Dr. Manuel Gea Gonzalez. We studied patients with diagnosis (by urethrography) of anterior urethral stricture prior to undergoing sonourethrography to determine the morphological characteristics of spongiofibrosis, including localization, thickness, and percentage of anterior urethral stricture, and its echographic characteristics. It was necessary to install a Foley catheter in the urethra, fastening it to the navicular fossa, to distend the anterior urethra with saline solution and explore it with an ultrasound machine and a 6 to 12 MHz linear transducer. Six male patients were included, in an age range of 18 to 68 years (average 54 years),
Results: the most common anatomical site of presentation was the bulbar urethra at 50%, followed by the penile urethra at 33%; the union of the penile and bulbar urethra accounted for 17%. The principal description of spongiofibrosis was echogenic in 83% of cases, and associated calcifications were found in 17% of the population. The thickness of spongiofibrosis varied between 2 and 64 mm (average 36.12 mm); the percentage of anterior urethral stricture was highly variable, in a range of 18.9 to 74.1% (average 65%).
Conclusion: sonourethrography is a useful, complete, effective, rapid, and low cost diagnostic method for study and monitoring of male patients with anterior urethral stricture. This analysis allowed us to observe the tissues surrounding the urethra and determine the percentage by which its diameter was reduced, a value closely associated with the patient’s symptoms. In some cases, it was possible to identify not only spongiofibrosis, but also calcifications; this information is relevant because the strength and hardness of calcifications reduce the patient’s therapeutic outlook.

REFERENCES

1. Wein: Cambell-Walsh, Urology, 10ma edición, capitulo 10, Ed. Elsivier, 2011.

2. Color Doppler US of the Postoperative Penis: Anatomy and Surgical Complications1, Radiographics, 2005, pág. 25:731–748

3. Bope and Kellerman Conn´s, Current Therapy o Urogenital Tract, 1a edición, Ed Elsiver, 2012.

4. Heidenreich A, Derschum W, Bonfig R, Wilbert DM, Ultrasound in the evaluation of urethral stricture disease: a prospective study in 175 pacientes, Br. J. Urology, 1994, july,74(1):93-8.

5. Ouattara DN, N´zin KP, Diabalé AS, Coulibaly N, Dédé NS, Yapo P, Blahoua B, Sugraré S, Djédjé AT, Velue of perineal sonography for diagnosing anterior urethral strictures, J. Radiology 2004, march.

6. Choudhary S, Singh P, Sundar E, Kumar S, Sahai A, A comparision of sonourethrography and retrograde urethrography in evaluation of anterior urethral stricture, Clínicas radiológicas 2004, agosto, 736-42.

7. Petris¸or Geavlete*, Victor Cauni, Dragos¸ Georgescu, Value of Preoperative Urethral Ultrasound in Optic Internal Urethrotomy, European Urology, 2004, Elsevier.

8. Joerg Seibold, Maren Werther et al, J. Urology, Urethral Ultrasound as a Screening Tool for Stricture Recurrence After Oral Mucosa Graft Urethroplasty, april 2011, Elsevier Inc.

9. Fernández GC, Rivas C, Rivas B, et al. Uretrosonografía. Comparación con la uretrografía convencional en la estenosis de uretra masculina. Radiología 2001;43(4):187-190.