Comparison of sonoelastography with sonourethrography and retrograde urethrography in the evaluation of male anterior urethral strictures

Abstract

Objective: Retrograde urethrography (RUG) is the most common and preferred imaging modality for imaging of the anterior urethral strictures despite its well-known limitations and disadvantages. Sonourethrography (SUG) was introduced in 1988 to overcome the limitations of RUG and to provide more accurate results. As proper selection of imaging modality is very important for planning the treatment, various advances in this area are required. One of the major factors for recurrence of stricture disease is spongiofibrosis. Sonoelastography (SE) is a newer technique, tried in various other pathologies. In this study, we have used this technique for the first time to assess its efficacy in the evaluation of anterior urethral stricture disease by comparison with RUG and SUG. Material and methods:Between August 2014 and May 2015, 77 patients with clinical features of anterior urethral stricture disease were included in the study and evaluated by RUG followed by SUG and SE for stricture location, length, depth of spongiofibrosis and periurethral pathologies. The results were then correlated with operative and histopathological findings. Results:Overall diagnostic accuracy of SE, SUG, and RGU for the estimation of stricture location, and length were estimated 92.68% vs. 91.54%, 79% vs. 78.87% and 80.48% vs. 43.66%, respectively, while for depth of spongiofibrosis SE, and SUG had accuracy rates of 87.3%, 48%, respectively. The mean length measured on SE was nearest to the mean intra-operative stricture length (21.34+11.8 mm). SE findings significantly correlated with the colour of bladder mucosa on cystoscopic examination (p=0.003) whereas the association was nonsignificant (p=0.127) for difficulty in incision. While a nonsignificant correlation existed between SUG findings related both to the colour of the bladder mucosa and difficulty in incision on cystoscopy, SE findings had a significant association (p<0.001) with histopathology findings for severe degree of fibrosis. Conclusion:Sonoelastography estimates stricture site and length better in comparison with RUG and SUG. It estimates degree of spongiofibrosis which serves as an important prognostic factor for stricture recurrence more accurately than SUG.

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

“…One is real-time elastography and the other is strain elastography (SE). [6] In this modality, tissue displacement in response to gentle pressure is used to compute and image tissue strain. SE measures the strain response of tissues in real time from sonography signals during externally applied compression-decompression cycles.…”

“…SE measures the strain response of tissues in real time from sonography signals during externally applied compression-decompression cycles. [6] As a semiquantitative elastographic technique, SE compares the elasticity and stiffness of target tissues with nearby normal ones. [7] Basic assumption of SE is that soft tissues can be more deformable than hard ones which can be displayed on US as a colour map overlaid to the grey scale image.…”

Effects of varicocele on testicles: Value of strain elastography: A prospective controlled study

“…SE and SWE are two elastography techniques. SE provides real‐time measurement of the tension response of the tissues from the sonographic signals during the externally applied compression–decompression cycle (Talreja et al, ). SE, which is a semi‐quantitative elastographic technique, compares the elasticity and hardness of the target tissues to the closer normal tissues, and the SR represents the hardness ratio of the target and normal tissues (Onur, Poyraz, Bozgeyik, Onur, & Orhan, ).…”

Comparison between cystourethrography and sonourethrography in preoperative diagnostic management of patients with anterior urethral strictures

“…This technique allows better accuracy in the evaluation of the stricture length, compared to RCUG. It also provides a higher accuracy in the measurements of stricture length and evaluation of spongiofibrosis, compared with standard SUG [20,21]. The novelty in SUG is the three-dimensional visualisation of urethral strictures [22].…”