Three-dimensional spiral computed tomographic cysto-urethrography for post-traumatic complex posterior urethral strictures associated with urethral-rectal fistula

Issue title: Recent Advances in Clinical Diagnosis and Therapeutics

Article type: Research Article

Authors: Sa, Ying Long | Xu, Yue Min | Feng, Chao | Ye, Xu Xiao | Song, Lu Jie

Affiliations: Department of Urology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China

Note: [] Corresponding author: Yue-Min Xu, MD. PhD., Department of Urology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, China. Tel.: +86 21 6436 9181, ext: 58698; Fax: +86 21 6764 7129; E-mail: xuyuemin@263.net

Abstract: To evaluate the value of three-dimensional spiral computed tomography/cysto-urethrography (CTCUG) in diagnosing posterior urethral strictures associated with urethrorectal fistulas (URF). Between June 2008 and March 2012, 38 patients with posterior urethral strictures associated with URFs were examined by CTCUG, retrograde urethrography (RUG) and cysto-urethrography (CUG). Urethral reconstruction was undertaken and URFs were surgically repaired in all patients. The length of the urethral defect, location and size of URFs were recorded. Data from radiological examinations were compared with surgical findings. No statistically significant difference was found in the length of stricture measured using CTCUG (4.31 ± 2.28 cm) or conventional urethrography (4.02 ± 3.12 cm; p > 0.05), However, the accuracy in determining the location of the stricture was higher with CTCUG (93.12%) than with conventional urethrography (70.59%; p < 0.05). CTCUG identified URFs in all 38 patients (100%), whereas URFs were only observed in 27 patients (71%) using conventional urethrography. In conclusion, CTCUG was more accurate, safer and provided more details of URFs and urethral defects than conventional urethrography in patients with posterior urethral strictures associated with URFs.

Keywords: Posterior urethral strictures, urethrorectal fistulas, CT, image analysis

DOI: 10.3233/XST-130360

Journal: Journal of X-Ray Science and Technology, vol. 21, no. 1, pp. 133-139, 2013