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Introduction:
Retrograde urethrography (RUG) is the gold standard for the diagnosis of male urethral stricture disease. This method requires instrumentation of the urethra, radiation exposure and in the pediatric population, general anesthesia. Current ultrasound techniques are able to mimic RUG with a faster and risk-free approach.
Materials and Methods:
Prior to voiding, a conventional 7.5 MHz transducer is placed at the perineum. The transducer is aligned along the line of the proximal corpus spongiosum. While angled at the prostate, the patient is instructed to void. The now opened lumen, can be followed distally by adjustments in the angle of the probe. This method allows visualization of a significant length of the urethra, though very distal strictures require an experienced hand.
Results:
Our initial series involves four boys with suspected urethral stricture. Chief complaints at presentation included hematuria, dysuria, splayed stream, and retention. All underwent sonographic urethrography (SUG), three underwent RUG, all had direct visualization internal urethrotomy, and two had dilation. Two boys required eventual urethroplasty. Sonographic urethrography was able to characterize strictures in three of the four boys. The ultrasound technique elicited no reports of discomfort.
Conclusion:
When presented with a pediatric patient with the suspicion of stricture, sonographic ultrasonography provides a quick and risk-free technique for diagnosis. This technique is able to characterize the presence and extent of urethral stricture.