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Urethrocystography remains the gold-standard technique for urethral pathology diagnosis. Nowadays, of the various indications for performing urethrocystography, the most common is due to a clinical suspicion of urethral stricture. Due to the high prevalence of strictures and their substantial impact on a patient’s quality of life, the examination must allow the location, exclusion of multifocality, and assessment of the extent of the stricture to influence surgical planning. This article intends to demonstrate that the radiologist’s role, by performing and interpreting the modality of urethrocystography, influences and is crucial for the urologic therapeutic decision and that the patients who were submitted to reconstruction by urethroplasty had a better success rate. The authors aim to review the radiological anatomy of the male urethra, discuss the modalities of choice for imaging the urethra (retrograde urethrography and voiding cystourethrography), provide an overview of the different indications for performing the study, examine the different etiologies for urethral strictures, understand the relevance of the different appearances of urethral pathology, and identify the surgical options, especially in the treatment of urethral strictures. Simultaneously, the study exposes cases of urethral trauma, fistulas, diverticulum, and congenital abnormalities.

Urethrocystography remains the gold-standard technique for urethral pathology diagnosis. Nowadays, of the various indications for performing urethrocystography, the most common is due to a clinical suspicion of urethral stricture. Due to the high prevalence of strictures and their substantial impact on a patient's quality of life, the examination must allow the location, exclusion of multifocality, and assessment of the extent of the stricture to influence surgical planning. This article intends to demonstrate that the radiologist's role, by performing and interpreting the modality of urethrocystography, influences and is crucial for the urologic therapeutic decision and that the patients who were submitted to reconstruction by urethroplasty had a better success rate. The authors aim to review the radiological anatomy of the male urethra, discuss the modalities of choice for imaging the urethra (retrograde urethrography and voiding cystourethrography), provide an overview of the different indications for performing the study, examine the different etiologies for urethral strictures, understand the relevance of the different appearances of urethral pathology, and identify the surgical options, especially in the treatment of urethral strictures. Simultaneously, the study exposes cases of urethral trauma, fistulas, diverticulum, and congenital abnormalities. [ABSTRACT FROM AUTHOR]

The urethra is a long muscular tubular organ that changes its internal configuration as it traverses different regions. Therefore, the pathology of each region is distinctive, and regional characteristics may influence exploration and treatment. We set out to perform detailed dissections of the male urethra and illustrate the regional specificity for each urethral segment. Therefore, we dissected the vesical cervix, showing both the normal appearance and the appearance of prostatic middle lobe adenoma. We dissected the prostatic urethra, showing the seminal colliculus, ejaculatory ducts, and prostatic utricle. We revealed the membranous urethra surrounded by the striated sphincter. We have shown the appearance of the spongy urethral bulb with its cul-de-sac appearance, the aspect of the urethral lacunae, the navicular fossa, and the external urethral meatus. We performed cross-sections through the prostatic urethra as well as dissection of the bulbourethral glands at the level of the urogenital diaphragm. All the information obtained through dissection is illustrated in high-quality graphic form and correlated with clinical applications, making this work valuable teaching material., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of University of Medicine and Pharmacy Carol Davila, Bucharest, Romania issued approval 9209. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Serbanoiu et al.)

Pathologies of the male urethra are mostly obstructive in nature and require imaging to delineate the lesion type, site, extent and associated abnormality of the urinary bladder. Contrast urethrography (CU) is the gold standard investigation for urethral assessment but has many limitations. Cross-sectional imaging is infrequently used for the evaluation of the urethra but has been gaining importance recently. Multidetector computed tomographic urethrography (MDCTU) has the capability of evaluating the entire length of a male urethra in a single setting and overcomes many technical and patient limitations of CU. Being a novel technique, most radiologists are not familiar with MDCTU and the imaging spectrum of various urethral and bladder pathologies. This pictorial review attempts to present the imaging appearance of the normal male urethra and spectrum of pathological findings, with highlights on its advantages over the CU technique.

Pathologies of the male urethra are mostly obstructive in nature and require imaging to delineate the lesion type, site, extent and associated abnormality of the urinary bladder. Contrast urethrography (CU) is the gold standard investigation for urethral assessment but has many limitations. Cross-sectional imaging is infrequently used for the evaluation of the urethra but has been gaining importance recently. Multidetector computed tomographic urethrography (MDCTU) has the capability of evaluating the entire length of a male urethra in a single setting and overcomes many technical and patient limitations of CU. Being a novel technique, most radiologists are not familiar with MDCTU and the imaging spectrum of various urethral and bladder pathologies. This pictorial review attempts to present the imaging appearance of the normal male urethra and spectrum of pathological findings, with highlights on its advantages over the CU technique. [ABSTRACT FROM AUTHOR]

To discuss the imaging appearances of various pathologies affecting adult male urethra and to review the role of imaging in the assessment of artificial urinary sphincters and penile prostheses. Diagnosis of common male urethral diseases heavily depends on two conventional fluoroscopic techniques namely retrograde urethrography and voiding cystourethrography. These are useful in evaluating common urethral diseases like traumatic injury, infections, and strictures. Cross-sectional imaging can be useful in evaluating periurethral pathologies. Artificial urinary sphincters, slings, and periurethral bulking agents are used in the management of urinary incontinence and imaging can be utilized to detect complications in these devices. Cross-sectional imaging especially MRI plays a significant role in evaluating the different types of penile prostheses and their malfunctioning. [ABSTRACT FROM AUTHOR]

Introduction: Müllerian clear cell carcinoma of the male urethra is similar to that of the female genital tract in terms of morphology and immunohistochemical expression but is rarely observed in clinical practice., Case Presentation: Here, we report the case of a 65-year-old man diagnosed with Müllerian clear cell carcinoma who harboured a mutation in RAD54L . This patient was diagnosed by electrocautery and ultimately underwent prostatectomy. After a six-month follow-up period, no signs of recurrence or additional malignancy were found. Based on our analysis of the available literature, it appears that Müllerian clear cell carcinoma with RAD54L mutation has not been reported until now., Conclusion: This case enhances our knowledge of the molecular biology of Müllerian clear cell carcinoma of the male urethra, which will help clinicians select optimal treatment options for this rare cancer in patients with specific driver mutations., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

To evaluate the characteristics of lichen sclerosus (LS) accompanied by urethral squamous cell carcinoma (USCC) and to raise urologists’ awareness about the early management of LS, a retrospective analysis was performed on the clinical features, diagnosis, treatment, and prognosis of 18 male genital LS accompanied by USCC patients who were referred to Shanghai Sixth People’s Hospital between June 2000 and August 2014. All of the patients had a long-term history of LS, urethral strictures, and urethral dilatation. Seven patients are with distal (glanular or penile) USCC, 10 patients with proximal USCC, and one with entire USCC. The most common presentation, except for LS and urethral strictures, was periurethral abscess, followed by extraurethral mass, pelvic pain, urethrocutaneous fistula, hematuria, and bloody urethral discharge. All had primary surgical excision that was adapted to tumor location and extension. All of the USCC were positive for P53 and Ki-67. P16 was positive in four cases of human papillomavirus (HPV)-associated USCC and negative in 14 cases of HPV-independent USCC. Patients with distal USCC had a significant longer survival time than proximal USCC (p < .05). LS should be treated early to prevent the disease progression. LS probably has some associations with USCC. Distal USCC has a relatively better prognosis than proximal USCC. [ABSTRACT FROM AUTHOR]

Urethral prolapse is a disease of prepubertal black girls and postmenopausal women with an unknown cause. It may be congenital in origin or an acquired condition. It has never been reported in males. We report a 10-year-old Caucasian boy who presented because of recurrent right undescended testis. He had been operated on for bilateral undescended testes 7 years ago in another hospital, and circumcision was done during the same operation. The boy complained of a weak urinary stream during voiding. The physical examination was consistent with recurrent right undescended testis. Penile examination showed a circumferential urethral prolapse around the meatus. The urethral meatal appearance was apparent right after the circumcision. An orchiopexy operation as well as circumferential excision of the perimeatal urethral tissue with primary repair was done. The pathological examination of the specimen revealed keratinized stratified squamous epithelium consistent with urethral mucosa. The postoperative course was uneventful, and the patient urinates normally at the 8 postoperative month with a normal uroflowmetry study. This is the first report of urethral prolapse in a male. Because circumcision is a widely employed practice in many cultures, it is unlikely to be a predisposing factor. It is a benign condition that can be cured with simple resection and anastomosis.

A case of primary malignant melanoma of the urethra in a 60-year-old male is presented. Despite multiple adverse prognostic factors and against expectations, after a follow-up of 5.5 years he is still alive.

Introduction: Urogenital tuberculosis is a frequent disease in endemic countries. It is characterized by clinical polymorphism. The isolated urethral form is exceptional, even in countries with endemic tuberculosis. We present a rare case of urogenital tuberculosis in a man revealed by urethral narrowing and multiple urethro-scrotal fistulas.Case Presentation: The patient, a Moroccan man, was 40 years old. He visited our hospital for a urology consultation and presented with dysuria, purulent discharge and a meatic penoscrotal fistula. A retrograde and voiding urethrocystography was performed and revealed an extended narrowing of the whole anterior urethra associated with multiple fistulous portions toward the scrotum and perineum. At this stage, we reached a diagnosis of nonspecific sclero-inflammatory urethral stricture with complicating fistulas. We decided to perform a urethroplasty enlargement to clear the narrowing urethral sinus tracts. The evolution was marked by delayed wound healing associated with the persistence of fistulas extending into the corpus cavernosum with purulent discharge. It was at this point in the treatment that we suspected tuberculosis. Multiple biopsies were then performed on the periurethral tissue and fistula tracts. The histological examination confirmed urethral tuberculosis and showed the presence of giant cell epithelial lesions with caseous necrosis characteristic of tuberculosis. The treatment for tuberculosis was immediately established and the evolution was marked by a localized, rapid and significant improvement. A second-stage urethroplasty was scheduled for two months after the start of his antituberculous treatment.Conclusions: Urogenital tuberculosis is common, but isolated urethral involvement is very rare even in countries with endemic tuberculosis. We urge practitioners, and especially urologists, to consider the disease in their investigation whenever given clinical signs are declared. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of radiologic images suggestive of urethral diverticula (UD) in men with spinal cord injury (SCI) and to study the interobserver diagnostic reproducibility. Methods: Radiological studies (i.e. voiding cystourethrography and retrograde urethrography) performed over 1 year on men with SCI were independently reviewed by 3 researchers (1 urologist and 2 radiologists). Results: The prevalence of UD was found to be between 4.2 and 9.8% of the patients, the higher figure obtained when including also the doubtful images. The kappa index of agreement between the researchers was low (between 0.15 and 0.40). The factors that significantly influenced agreement were localization in the prostatic urethra (p = 0.021), localization in the penile urethra (p = 0.000) and fusiform morphology (p = 0.004). Logistic regression analysis showed that the variables that independently influenced diagnostic agreement were the following: localization in the penile urethra (in favor of agreement) and fusiform morphology (against agreement). Conclusions: Radiologic images suggestive of UD constitute a frequent finding in men with SCI and raise important diagnostic problems. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the value of transrectal sonourethrography in the diagnosis of dysuria after bipolar transurethral plasmakinetic prostatectomy (TUPKP). Seventy-seven male patients with dysuria after TUPKP underwent transrectal sonourethrography. The clinical data were then compared with the surgical outcomes. The following pathologies were diagnosed: Bladder neck atresia (17/77), bladder orifice strictures (15/77), membranous urethral strictures (21/77), pa cavernosa urethral stricture (12/77), residual prostate gland (5/77), external urethral orifice stricture (2/77), calculi in th prostatic urethra (2/77), flap in the internal urethral orifice (2/77), and postoperative dysfunction of the bladder detrusor muscle (1/77). Transrectal sonourethrography is a reliable diagnostic method for numerous pathologies that occur in patients with dysuria after TUPKP and is a clinically useful tool. [ABSTRACT FROM AUTHOR]

We present a 76-year-old male patient, who was diagnosed with transitional cell carcinoma (TCC) of the distal part of the urethra. Transurethral resection of the tumor (TURT) of the urethra was conducted. After establishing local relapse, surgical removal of the distal part of the urethra was proposed to the patient. Due to no consent for an open surgery, another electroresection of the tumor was performed. When the second relapse occurred, the patient provided his consent for surgical removal of the part of the urethra with anastomosis of the remaining part of the urethra with the skin from the abdominal part of the penis. Postsurgical observation did not reveal any local relapse. [ABSTRACT FROM AUTHOR]

Congenital anterior urethral diverticula in adult males are infrequent urological diseases. Clinical manifestation is frequently described with irritative and/or obstructive voiding symptoms or ventral bulging, but manifestation as a scrotal mass is extremely rare. Diagnostic imaging is useful to correctly diagnose the above in the majority of cases. We report the first case of a urethral diverticulum in which neither clinical nor instrumental evaluations were performed to confirm the diagnosis of urethral diverticulum. We stress the importance of a surgical approach in evaluating scrotal mass if diagnostic imaging cannot confirm an exact diagnosis. A complete review of the literature was also carried out. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]