Imaging of Urethral Disease: A Pictorial Review

Kawashima, Akira; Sandler, Carl M.; Wasserman, Neil F.; LeRoy, Andrew J.; King, Bernard F.; Goldman, Stanford M.

doi:10.1148/rg.24si045504

Cited by 210 publications

(145 citation statements)

References 40 publications

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“…It is a simple, easy and low-cost approach, as it requires only conventional X-ray imaging and the retrograde injection of diluted contrast agent to examine the lower urinary tract (13,14). However, since X-ray photographs obtained in the anteroposterior and double oblique views are overlapped images, and the procedure is invasive, the feasibility of this type of examination is limited (4,15).…”

Section: Discussionmentioning

confidence: 99%

640-slice DVCT multi-dimensionally and dynamically presents changes in bladder volume and urine flow rate

Fang

Mao

et al. 2017

Exp Ther Med

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Abstract. The present study aimed to explore the application of 640-slice dynamic volume computed tomography (DVCT) to excretory cystography and urethrography. A total of 70 healthy subjects were included in the study. Excretory cystography and urethrography using 640-slice DVCT was conducted to continuously record the motions of the bladder and the proximal female and male urethra. The patients' voiding process was divided into early, early to middle, middle, middle to late, and late voiding phases. The subjects were analyzed using DVCT and conventional CT. The cross-sectional areas of various sections of the male and female urethra were evaluated, and the average urine flow rate was calculated. The 640-slice DVCT technique was used to dynamically observe the urine flow rate and changes in bladder volume at all voiding phases. The urine volume detected by 640-slice DVCT exhibited no significant difference compared with the actual volume, and no significant difference compared with that determined using conventional CT. Furthermore, no significant difference in the volume of the bladder at each phase of the voiding process was detected between 640-slice DVCT and conventional CT. The results indicate that 640-slice DVCT can accurately evaluate the status of the male posterior urethra and female urethra. In conclusion, 640-slice DVCT is able to multi-dimensionally and dynamically present changes in bladder volume and urine flow rate, and could obtain similar results to conventional CT in detecting urine volume, as well as the status of the male posterior urethra and female urethra.

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Section: Discussionmentioning

confidence: 99%

640-slice DVCT multi-dimensionally and dynamically presents changes in bladder volume and urine flow rate

Fang

Mao

et al. 2017

Exp Ther Med

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“…The striated muscle fibers run in a cranial direction from the bulb of the penis to the base of the bladder along the anterior and lateral aspects of the prostate and the membranous urethra [11]. Besides, when the posterior urethra is opacified suboptimally, the bulbomembranous junction can be arbitrarily localized [12]. …”

Section: Discussionmentioning

confidence: 99%

Study of the Prevalence and Interobserver Reproducibility of Radiologic Images Suggestive of Urethral Diverticula in Men with Spinal Cord Injury

Chamorro

Rubio²,

Florensa³

et al. 2013

Urol Int

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Objectives: To determine the prevalence of radiologic images suggestive of urethral diverticula (UD) in men with spinal cord injury (SCI) and to study the interobserver diagnostic reproducibility. Methods: Radiological studies (i.e. voiding cystourethrography and retrograde urethrography) performed over 1 year on men with SCI were independently reviewed by 3 researchers (1 urologist and 2 radiologists). Results: The prevalence of UD was found to be between 4.2 and 9.8% of the patients, the higher figure obtained when including also the doubtful images. The kappa index of agreement between the researchers was low (between 0.15 and 0.40). The factors that significantly influenced agreement were localization in the prostatic urethra (p = 0.021), localization in the penile urethra (p = 0.000) and fusiform morphology (p = 0.004). Logistic regression analysis showed that the variables that independently influenced diagnostic agreement were the following: localization in the penile urethra (in favor of agreement) and fusiform morphology (against agreement). Conclusions: Radiologic images suggestive of UD constitute a frequent finding in men with SCI and raise important diagnostic problems.

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“…Tumors in the distal urethra may extend into the adjacent perineum and the target-like appearance of the normal urethra on axial T2-weighted images may be disrupted (15). CT may reveal a urethral mass with soft-tissue attenuation (16). Transvaginal ultrasonograpy may also provide clues for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Management of primary adenocarcinoma of the female urethra: Report of two cases and review of the literature

Wang

Bai

et al. 2012

Oncology Letters

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Abstract. Primary adenocarcinoma of the female urethra is rare and only a few retrospective cases have been published. The origin of urethral adenocarcinomas remains unclear. Certain authors have suggested that urethral adenocarcinomas in females originate at the periurethral Skene's glands. We report one case of urethral adenocarcinoma of the proximal urethra in a 44-year-old female who presented with painless urethral bleeding. Abdominal and pelvic CT scan with contrast and chest radiology were unremarkable. Biopsy of the mass revealed adenocarcinoma of the urethra. The patient was treated with partial urethrectomy and was free of disease for more than 5 years. We also present another rare case of mucinous adenocarcinoma in a 52-year-old female who complained of an enlarged urethral mass. Pelvic MRI revealed a tumor surrounding the whole urethra and bilateral inguinal lymph nodes. A puncture biopsy later revealed that the tumor was mucinous adenocarcinoma. Anterior pelvic exenteration with pelvic and bilateral lymph node dissection was performed and chemotherapy was administered. The patient was followed up for 12 months and did not experience local recurrence or distant metastasis. In conclusion, for the diagnosis of urethral cancer, a biopsy is necessary for any suspicious urethral lesions. MRI is recommended for tumor staging. Small, superficial, distal urethral tumors may be treated with excision of the distal urethra. For advanced female urethral cancer, a combination of chemotherapy, radiation therapy and surgery is recommended for optimal local and distant disease control. Regular follow-up is required in these patients. IntroductionFemale urethral carcinoma is rare and accounts for approximately 0.02% of all female cancers and less than 1% of cancers in the female genitourinary tract (1). In females, squamous cell carcinoma is the most common histological type, accounting for 70% of all cases. Transitional cell carcinoma (20%) and adenocarcinomas (8-10%) are the next most common cell types (2). Most patients are symptomatic at presentation. Certain patients may present with obstructive symptoms, dysuria, urethral bleeding, urinary frequency and often a palpable urethral mass or induration. The evaluation of females with suspected urethral carcinoma includes cystourethroscopy, physical examination, CT and MRI of the abdomen and pelvis and chest radiography. The prognosis is determined largely by the clinical stage and the location of the lesions. Tumors in the distal urethra tend to have a better outcome (3).Primary adenocarcinoma of the female urethra is extremely rare with only a few retrospective cases published. We report two cases of female urethral adenocarcinoma, including a rare case of mucinous adenocarcinoma. The study was approved by the ethics committee of Zhongshan Hospital, Xiamen University, China. Informed consent was obtained from each patient. Case 1A 44-year-old female patient complained of painless occasional urethral bleeding over the previous 2 months. Physical examination revealed...

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Imaging of Urethral Disease: A Pictorial Review

Cited by 210 publications

References 40 publications

640-slice DVCT multi-dimensionally and dynamically presents changes in bladder volume and urine flow rate

640-slice DVCT multi-dimensionally and dynamically presents changes in bladder volume and urine flow rate

Study of the Prevalence and Interobserver Reproducibility of Radiologic Images Suggestive of Urethral Diverticula in Men with Spinal Cord Injury

Management of primary adenocarcinoma of the female urethra: Report of two cases and review of the literature

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