Department of Urology and Radiology, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
J Urol. 2010 Oct;184(4 Suppl):1699-702. doi: 10.1016/j.juro.2010.03.074. Epub 2010 Aug 21.
Accurate measurement of anterior urethral stricture length is critical to determine the appropriate surgical approach. Retrograde urethrogram is often used to determine stricture location and length. However, the adult literature shows that retrograde urethrogram may underestimate stricture length. We investigated the role of sonographic urethrogram in the preoperative evaluation of adolescent urethral stricture disease.
Between June 2008 and February 2009 we retrospectively evaluated 12 pediatric patients with urethral stricture disease using retrograde and sonographic urethrogram. Stricture length was categorized by 2 radiologists as I-less than 1, II-1 to 3 and III-greater than 3 cm. On sonographic urethrogram stricture length was measured as the longest extent of the urethral abnormality.
Mean patient age was 16.9 years (range 9.5 to 20.8). Retrograde urethrogram classified 7 cases as category I, 4 as category II and none as category III stricture, and 1 with no evidence of stricture. Sonographic urethrogram revealed strictures greater than 1 cm in all 7 category I cases and 2 of the 4 category II cases had strictures longer than 3 cm. One patient in whom retrograde urethrogram showed a category II stricture was stricture-free on sonographic urethrogram. One patient with a negative retrograde urethrogram had a stricture on sonographic urethrogram. Sonographic urethrogram upgraded stricture length in 10 of the 12 patients and outperformed retrograde urethrogram in 11.
Sonographic urethrogram is effective for evaluating adolescent urethral stricture disease. It may provide more accurate measurement of stricture length and improve preoperative planning.
准确测量前尿道狭窄的长度对于确定合适的手术方法至关重要。逆行尿道造影常用于确定狭窄的位置和长度。然而，成人文献表明，逆行尿道造影可能低估了狭窄的长度。我们研究了超声尿道造影在青少年尿道狭窄疾病术前评估中的作用。
2008 年 6 月至 2009 年 2 月，我们回顾性评估了 12 例患有尿道狭窄疾病的儿科患者，使用逆行和超声尿道造影。2 名放射科医生将狭窄长度分为 I-小于 1cm、II-1 至 3cm 和 III-大于 3cm。在超声尿道造影中，狭窄长度测量为尿道异常的最长范围。
患者平均年龄为 16.9 岁（范围 9.5 至 20.8 岁）。逆行尿道造影将 7 例归类为 I 类，4 例归类为 II 类，无 III 类狭窄，1 例无狭窄证据。超声尿道造影显示 7 例 I 类病例中所有病例的狭窄均大于 1cm，4 例 II 类病例中有 2 例的狭窄长度大于 3cm。逆行尿道造影显示为 II 类狭窄的 1 例患者在超声尿道造影中无狭窄。逆行尿道造影阴性的 1 例患者在超声尿道造影中有狭窄。超声尿道造影在 12 例患者中的 10 例中升级了狭窄长度，在 11 例中优于逆行尿道造影。
超声尿道造影对评估青少年尿道狭窄疾病有效。它可能提供更准确的狭窄长度测量，并改善术前计划。
