Comparative Utility of Urethrosonography Versus Classic Techniques in Diagnosing Urethral Stricture: A Single Center Study

Accurate preoperative assessment is critical for successful urethral reconstruction, yet the traditional armamentarium—retrograde urethrography and cystourethroscopy—remains invasive, radiating, and sometimes suboptimal for surgical planning. This study explores urethrosonography (US) as a modern, patient-friendly alternative.

In a cohort of 33 men undergoing urethral stricture repair, US demonstrated strong concordance with intraoperative findings, particularly excelling in stricture length estimation compared to conventional imaging. More importantly, the US provided unique insight into spongiofibrosis, an aspect critical for deciding between excision and substitution urethroplasty, which is rarely assessed by classic radiographic studies.

Clinically, these findings matter. A well-performed urethrosonogram offers the reconstructive surgeon not only anatomical accuracy but also functional context, without radiation exposure and with minimal patient discomfort. For selected cases, this could reduce reliance on retrograde urethrography, streamline preoperative workup, and improve patient experience.

Future steps should include defining which patient profiles benefit most from US, standardizing the technique across centers, and integrating its findings into surgical decision algorithms. As reconstructive urology evolves toward precision and patient-centered care, urethrosonography may well become a key diagnostic pillar rather than an adjunct.

Written by: Miguel Palau Roig, Sarai Margarita Botto Lugo, Pilar Martínez Albaladejo, Ana Utiel Atienzar, Maria de los Desamparados Cuenca Ramírez, David González Díez, Raúl Ferrer Grau, Jorge Planelles Gómez, María Jesús Martínez-Pérez, and Juan Francisco Vidal Moreno

Hospital Universitario Doctor Peset, Valencia, Spain

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