MRI of acquired posterior urethral diverticulum following surgery for anorectal malformations

Abstract

Pelvic MRI can be a useful tool in the postoperative assessment of suspected PUD associated with ARM. Radiologists should have a high clinical suspicion for a postoperative PUD when a cystic lesion posterior to the bladder/posterior urethra is encountered on two imaging planes in these patients.

Complications after Surgical Correction of Anorectal Malformations

“…31,36 There have been some radiographic reports about posterior urethral diverticulum, and in some cases, posterior urethral diverticula could not be revealed using voiding cystourethrography, being detectable only using MRI. 10,11,16,18 Histopathology of the excised mucosa of the cyst showed colonic mucosa and confirmed that cyst was indeed an enlarged residual rectourethral fistula. 16 To prevent posterior urethral diverticula, novel surgical approaches and enhanced surgical skills are required.…”

“…dysuria, formation of urinary stones, infection, and malignancy. 10,16,18,19 Meanwhile, some patients with posterior urethral diverticula may not exhibit any symptoms. 10,16,18,19 Therefore, it may be accidentally detected on an MRI performed to evaluate the levator ani muscle.…”

“…10,16,18,19 Meanwhile, some patients with posterior urethral diverticula may not exhibit any symptoms. 10,16,18,19 Therefore, it may be accidentally detected on an MRI performed to evaluate the levator ani muscle. 31,36 There have been some radiographic reports about posterior urethral diverticulum, and in some cases, posterior urethral diverticula could not be revealed using voiding cystourethrography, being detectable only using MRI.…”

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Various imaging techniques, such as plain radiography, colonography, voiding cystourethrography, ultrasonography, computed tomography, and magnetic resonance imaging (MRI) can be used for diagnosis. 9,11,16,18,19,21,29,30 Unlike surgeons, radiologists are often unfamiliar with ARMs and have little knowledge about the surgical procedures for their repair; to date, only one review article related to radiography has been published. 30 The aim of this article was to familiarise radiologists with common complications of specific surgical approaches and ARM types, which would be useful in diagnosis and in assisting surgeons with the management of these complications.…”

Reoperative surgery in anorectal malformation patients

“…This complication underscores the importance of precisely defining the location of the fistula prior to the index operation-considered by some to be the most important information to be obtained in the preoperative evaluation (26). When evaluating a patient for a redo operation, a PUD/ROOF may be detected via cystoscopy (Figure 4), VCUG or sometimes pelvic MRI (27).…”