U rethral stricture is one of the common male urological disorders with an increasing incidence. Patients may be asymptomatic or present with decreased urine flow, increased pressure required for urinating, a feeling of incomplete urination, urinating in a drop by drop manner and urinary retention. Moreover, ejaculation disorders, often underestimated by physicians, may be encountered, significantly influencing patients' quality of life (1).Stricture might be caused by inflammatory, traumatic, ischemic, congenital or iatrogenic factors resulting in formation of scar tissue along the tract and reducing the caliber of the urethra (2). Disease is associated with high recurrence rate. Mechanisms underlying traumatic strictures include straddle injury, pelvic fracture-related urethral injury and iatrogenic injury secondary to instrumentation also in reference to worldwide increase in endoscopical transurethral treatment methods in the last decades (3).Given that the number of patients suffering from urethral stricture disease is increasing, there is a need for improvement of diagnostic methods determining the choice of the optimal treatment method. Despite numerous surgical methods for treatment of this disease, it is still associated with high recurrence rates.Process of stricture formation is usually associated with scarring within corpus spongiosum and is known as spongiofibrosis. Histological and immunohistochemical studies showed significant changes within the structure of the strictured part of urethral wall in the microscopic images. In contrast to normal urethra wall, the epithelial layer at the site of a stricture is much thicker. Collagen and bundles of elastin are densely packed around the strictured urethra (4). Thus, the most effective method of treatment for patients with urethral stricture with extensive spongiofibrosis is excision of the whole stricture followed by an end-to-end anastomosis of the two healthy ends (5). Therefore, more and more radiologists and urologists require information on the presence of spongiofibrosis and periurethral pathologies for the correct choice of treatment method.
Methods of urethral stricture evaluation
UrethroscopyDespite the fact that urethroplasty has a much higher long-term success rate and better outcomes in terms of recurrence rate than dilatations and urethrotomies, minimally invasi-ABSTRACT Magnetic resonance imaging (MRI) is gaining acceptance as a diagnostic tool in urethral stricture disease. Numerous publications emphasize on the advantages of MRI including its ability to determine periurethral spongiofibrosis, thus overcoming the main limitation of retrograde urethrography (RUG). It is also becoming an alternative for sonourethrography (SUG), which is a highly subjective examination. Magnetic resonance urethrography (MRU) has become an increasingly appreciated tool for diagnosing patients with urethral stricture disease. Obtained data provides radiologists and urethral reconstructive surgeons with additional information regarding anatomical relationships a...