Abstract

Objective: To study the role of magnetic resonance imaging in assessment of posterior urethra distraction defects with respect to location, length and depth of scar involved.

Methods: This was a prospective observational study. Patients aged 18-70 years, diagnosed with posterior urethral defect on conventional retrograde and voiding cystourethrography method were included in the study. All the patients planned for surgery had undergone MRI pelvis. All of the patients included in the study got a RGU/MCU done.

Results: Half of patients were below 30 years of age (50%). About one third of patients were between 30-50 years (30%). Road traffic accident was the most common cases of posterior urethral distraction defects (50%). Short Segment Stricture were in 6 (30%) of subjects on conventional retrograde urethrography combined with voiding cystourethrography, 8 (40%) on Magnetic Resonance Urethrography, 9 (45%) were at intraoperatively. Stricture was present at membranous part of urethra in 14 (70%) of subjects on conventional retrograde urethrography combined with voiding cystourethrography, 16 (80%) on Magnetic Resonance Urethrography and Intraoperatively. Periurethral fibrosis did not demonstrated in conventional retrograde urethrography combined with voiding cystourethrography, but Magnetic Resonance Urethrography imaging demonstrated periurethral fibrosis in 4(20%) patients.

Conclusion: MR urethrography is a promising tool for defining posterior male urethral strictures as an alternative to traditional radiographic methods. The future of MR Urethrography in the evaluation of posterior urethral distraction defects is mainly in cases with complex urethral distraction injuries, patients with multiple fistulae and in children.

Keywords: Magnetic resonance imaging, Posterior urethral distraction, Retrogradeurethrography, Voiding cystourethrography.