Comparative utility of urethrosonography versus classic techniques in diagnosing urethral stricture: a single center study.

PURPOSE

To evaluate the utility and complications of urethrosonography (US) in the preoperative assessment of urethral stricture compared to traditional diagnostic methods and its impact on therapeutic decision-making.

METHODS

A prospective observational study was conducted on male patients diagnosed with urethral stricture who were candidates for surgical treatment. Preoperative assessment included flexible urethrocystoscopy, voiding cystourethrography (VCUG), and US. Demographic and epidemiological data were recorded and analyzed. Sensitivity and specificity were calculated. Agreement between diagnostic techniques was assessed using the Cohen's Kappa coefficient. The impact of findings on surgical decision-making was evaluated, and potential complications associated with each technique were documented.

RESULTS

Thirty-three male patients with a mean age of 59.5 years, diagnosed with urethral stricture who were candidates for surgical treatment, were evaluated. No statistically significant differences were found in the location or severity of the stricture among the different techniques, with good concordance with intraoperative findings. US demonstrated higher sensitivity (60% vs. 44.2%) and specificity (87.8% vs. 84.9%) compared to VCUG in assessing the length of the stricture, and was also more accurate than urethrocystoscopy in determining the degree of spongiofibrosis (77.02% vs. 69.11% for sensitivity, and 81.9% vs. 74.5% for specificity). The choice of preoperative technique influenced the selection of the surgical approach.

CONCLUSIONS

Urethrosonography is more sensitive and specific than traditional techniques in determining the length of the stricture, with similar concordance with intraoperative findings. It may serve as an alternative to conventional diagnostic tests in the preoperative evaluation of urethral stricture, offering several advantages such as the absence of radiation, lower complication rates, and its non-invasive nature.