E5271. Urethral and Periurethral Disorders: An Imaging Tour
Authors
Sriram Jaganathan;
University of Texas Health Science center
Mohd Zahid;
University of Alabama
Bryan Foster;
Oregon Health and Science University
Priya Bhosale;
MD Anderson cancer center
Mayur Virarkar;
University of Florida
Hagar Samir Mahmoud;
University of Connecticut
Apurva Bonde;
University of Texas Health Science center
Background
Conventional imaging techniques such as cystography, voiding cystourethrography, and double balloon urethrography, though still play a reasonable role, are limited to evaluating the urothelium. Hence, the cross-sectional imaging modalities including ultrasound (US), CT, and MRI play a crucial role in the evaluation of the varied spectrum of urethral and periurethral disorders. With technical advancements including high-resolution probes, endocavitary probes, and 3D imaging, the US still holds an important place in urethral evaluation. The superior soft tissue resolution of MR makes it unique and a problem-solving tool in the detailed evaluation of urethral and periurethral disorders. Our exhibit reviews the normal imaging anatomy, and spectrum of the abnormalities of male and female urethra on different imaging modalities, including relevant functional imaging for pelvic floor dysfunction and relevant periurethral pathologies.
Educational Goals / Teaching Points
Describe the normal anatomy of the male and female urethra on various imaging modalities. Describe the current role of imaging in the evaluation of urethral and periurethral diseases, including selective postoperative appearances. Display imaging spectrum of the abnormalities of male and female urethra on different imaging modalities, including relevant functional imaging for pelvic floor dysfunction.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Our exhibit reviews the normal imaging anatomy, and spectrum of the abnormalities of male and female urethra on different imaging modalities, including relevant functional imaging for pelvic floor dysfunction and relevant periurethral pathologies. The various urethral pathologies included in the presentation are infections and their complications including periurethral abscess, stricture, and fistula; urethral and periurethral malignancies; urethral involvement by other urogynecological malignancies; urethral diverticulum and its complications; urethral injuries; caruncle; benign conditions like leiomyoma; and inflammatory diseases such as lichen sclerosis and amyloid. Additionally, periurethral diseases including cysts, differentiation between Skene’s gland cysts, Bartholin cysts, and Gartner's duct cysts are detailed with illustrations. Postoperative appearances of male urethra including prostatectomy, TURP and urethral reconstruction, and postoperative appearances of female urethra including urethral sling surgeries and injection of bulk agents are shown. The exhibit also includes functional imaging for urethral hypermobility and urethrocele/cystocele.
Conclusion
Understanding the anatomy and imaging appearances of varied pathologies of male and female urethral and periurethral diseases helps the radiologist play a key role in the management of urological conditions.
