Imaging spectrum of traumatic urinary bladder and urethral injuries

Wongwaisayawan, Sirote; Krishna, Satheesh; Sheikh, Adnan; Kaewlai, Rathachai; Schieda, Nicola

doi:10.1007/s00261-020-02679-0

Cited by 6 publications

(1 citation statement)

References 55 publications

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“…The pathophysiological basis of urinary difficulties caused by prostatic hyperplasia obstruction is urethral deformation, involving the elongation of the prostatic urethra, luminal narrowing, and a narrowed bladder neck opening. Multislice spiral CT urethrography can detect changes caused by BOO, but quantifying the degree of obstruction and stenosis in the bladder neck and posterior urethral lumen, as well as changes in urethral patency postprostatectomy, is rarely reported in clinical practice ( Ishii et al, 2019 ; Kwon et al, 2019 ; Minagawa et al, 2019 ; Su et al, 2018 ; Wongwaisayawan et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Application of Urethral Contrast Computed Tomography Three-Dimensional Imaging in the Postoperative Assessment of Prostate Hyperplasia

Zhang,

Zhou,

et al. 2024

Am J Mens Health

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This study assesses the morphological effectiveness of benign prostatic hyperplasia (BPH) surgery using multislice spiral computed tomography three-dimensional imaging (CT3D) with urethral contrast. Twenty-five male patients with BPH and bladder outlet obstruction (BOO) who underwent bipolar transurethral resection of the prostate were selected. Preoperative and postoperative CT3D indicators of retrograde and voiding cystourethrography, including bladder neck diameter, length of the posterior urethra, and degree of prostate protrusion into the bladder and upper and lower diameter of the prostate were used to assess bladder neck and posterior urethra morphology and BOO severity. In addition, preoperative and postoperative International Prostate Symptom Scores and maximum urine flow rates were compared. Postoperative CT3D was used to evaluate changes following obstruction relief postsurgery. Preoperative CT3D indicated significant BOO, whereas postoperative imaging showed improved patency but with irregular posterior urethral lumens and varying degrees of residual glandular tissue. Comparative analysis of preoperative and postoperative bladder outlet metrics revealed significant changes ( p < 0.05). Urethral contrast CT3D effectively visualizes the prostate, bladder neck, and prostatic urethra. It quantifies changes in the urethral lumen postsurgery, correlating the extent of posterior urethral lumen spaciousness with urinary flow rates.

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Section: Discussionmentioning

confidence: 99%

Application of Urethral Contrast Computed Tomography Three-Dimensional Imaging in the Postoperative Assessment of Prostate Hyperplasia

Zhang,

Zhou,

et al. 2024

Am J Mens Health

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Contrast‐Enhanced Ultrasound: A Real‐Time, Noninvasive, Radiation‐Free Method for Intraoperative Male Urethral Fistula Assessment

Lu,

Liu,

Chen

2024

J of Ultrasound Medicine

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ObjectivesTo evaluate the feasibility of intraoperative transurethral contrast‐enhanced ultrasound for the assessment of male urethral fistulas.MethodsPatients in a prospective database who underwent intraoperative two‐dimensional ultrasound, transurethral saline‐enhanced ultrasound, and contrast‐enhanced ultrasound between January 2017 and July 2022 were included. All patients were clinically diagnosed with urethral fistulae (UF) in the outpatient setting based on clinical presentations, traditional two‐dimensional ultrasound, and/or other imaging modalities and confirmed during surgical repair. Dynamic videos of the scans were independently analyzed by two experienced ultrasonologists.ResultsThirty‐nine patients with an average age of 51 years were included. The UF were located in the anterior urethra in 22 (56.4%) patients and in the bulbar urethra in 14 (63.6%) patients. UF were located in the posterior urethra in 17 (436%) patients and in the prostatic urethra in 13 (76.5%) patients. Contrast‐enhanced ultrasonography revealed UF in all patients. In patients with anterior UF, saline‐enhanced ultrasound images did not show a UF in 15 (68.2%, 15/22) patients, 13 (86.7%, 13/15) of whom had fistulae with diameters <3 mm. Saline‐enhanced ultrasound images did not reveal posterior UF in 13 (76.5%, 13/17) patients. The fistula diameters in eight (61.5%, 8/13) patients were <3 mm. The duration for contrast‐enhanced ultrasonography was approximately 3 minutes. The duration for surgical repair was approximately 2 hours.ConclusionsTransurethral contrast‐enhanced ultrasound is a real‐time, noninvasive, and radiation‐free method that allows intraoperative imaging and accurate assessment of male UF. Its sensitivity is higher than that of both two‐dimensional ultrasound and transurethral saline‐enhanced ultrasound. The location, size, and course of the fistulae can be clearly seen due to greater contrast during contrast‐enhanced ultrasound.

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Anatomopathology of Urinary Bladder Injury

AL-Mamari

2023

Urogenital Trauma: A Practical Guide

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Imaging spectrum of traumatic urinary bladder and urethral injuries

Cited by 6 publications

References 55 publications

Application of Urethral Contrast Computed Tomography Three-Dimensional Imaging in the Postoperative Assessment of Prostate Hyperplasia

Application of Urethral Contrast Computed Tomography Three-Dimensional Imaging in the Postoperative Assessment of Prostate Hyperplasia

Contrast‐Enhanced Ultrasound: A Real‐Time, Noninvasive, Radiation‐Free Method for Intraoperative Male Urethral Fistula Assessment

Anatomopathology of Urinary Bladder Injury

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