Ultrasound evaluation of the male urethra for assessment of urethral stricture

Radiographic retrograde urethrography has traditionally been the preferred technique used by urologists to image the anterior urethra. Since originally described by McAninch in 1988, ultrasonic imaging of the urethra has evolved into a powerful and clinically useful tool for the accurate delineation of urethral pathology. Although posterior urethral and peri- urethral fibrosis cannot be assessed reliably using this technique, sono- urethrography has proven to be more accurate than conventional radiographic urethrography in measuring stricture length throughout the anterior urethra. Herein we describe the evolution of sono-urethrography, explain its many advantages over traditional imaging techniques, and show clinical examples of its importance in guiding the successful reconstruction of urethral strictures, particularly in the bulbar area.