Avtor/Urednik     Babnik-Peskar, Darja; Višnar-Perovič, Alenka
Naslov     Strictures of the male urethra: how to perform and evaluate radiourethrography and sonourethrography to avoid mistakes
Prevedeni naslov     Zožitev moške sečnice: pravilna izvedba in vrednotenje radiografske in ultrazvočne uretrografije, da se izognemo napakam
Tip     članek
Vir     Radiol Oncol
Vol. in št.     Letnik 34, št. 2
Leto izdaje     2000
Obseg     str. 175-84
Jezik     eng
Abstrakt     Introduction. Precise evaluation of the uretheral stricture localisation, length, depth and quality of wall changes are necessary for the selection of the optimal treatment to prevent recurrences. Decision for urethral dilatation, internal urethrotomy or open surgery depends on urethroscopic, radiourethrographic-RUG, and recently, according to MC Annich, also sonourethrographic-SUG results. SUG adds information about the depth and density of spongiofibrosis. Previously published findings of RUG length underestimation, compared to SUG and endoscopy, were responsible for inappropriate treatment and recurrences. In our article, we evaluate SUG as a new imaging method in the diagnosis of uretheral strictures and treatment planning, and describe both imaging methods together with usual pitfalls in performance or interpretation, possible reason for incorrect length measurements, and RUG length underestimation. Patients and methods. In the period of 20 months, we evaluated SUG compared to RUG and endoscopy in 51/130 males with suspected urethral strictures. Results. Compared to RUG, sonography was correct in 92% radiographycally detected strictures. Length measurements by sonography were 22% shorter than radiographic lengths, which could be explained by radiographic magnification, as it was proved with wire measure placed on penis. Considering radiographic magnification, we did not find important differences in any measurement. Opposite to previously published RUG results compared to endoscopy and SUG, radiographic length underestimation was not found. Conclusions. The combination of both imaging methods provides optimal information about urethral stricture anatomy. We conclude that published radiographic length underestimation could be only a misinterpretation. (Abstract truncated at 2000 characters).
Izvleček     Izhodišče. Natančna ocena mesta, dolžine, globine in sestave zožitve sečnice so pogoj za pravilno odločitev o zdravljenju, da preprečimo recidive. Odločitev o dilataciji, interni uretrotomiji ali odprtem kirurškem posegu zavisi od endoskopske, radiouretrografske in v zadnjem času tudi ultrazvočne ocene po Mc Annich-u. Dodatna informacija ultrazvoka je neposredna ocena globine in sestave spongiofibroze. V predhodnih objavah ugotovljena radiografska podcenitev dolžine, v primerjavi z ultrazvokom in endoskopijo, je možen razlog nepravilnega izbora zdravljenja in recidivom. V prispevku smo ocenili novo ultrazvočno diagnostično možnost pri zožitvah sečnice. Opisali smo obe slikovni metodi v diagnostiki zožitev sečnice važnih za izbor zdravljenja, skupaj z običajnimi napakami v izvedbi in vrednotenju, ki so po našem prepričanju vzrok napačnim izmeram in predhodno objavljeni radiografski pocenitvi dolžine. Bolniki in metode. V obdobju 20 mesecev smo pri 51/130 moških s sumom na zožitev sečnice, ocenili ultrazvočno uretrografijo v primerjavi z radiouretrografijo in endoskopijo. Rezultati. V primerjavi z RUG je bil ultrazvok 92-odstotno pravilen v odkrivanju zožitev. Ultrazvočno izmerjene dolžine striktur so bile v povprečju za 22% krajše od radiografskih izmer, kar lahko razložimo z radiografsko povečavo, ki smo jo dokazali z merilno žico postavljeno na penis. Ob upoštevanju radiografske povečave, drugih bistvenih razlik v večini meritev nismo našli. V naši primerjavi RUG, SUG in endoskopije nismo našli predhodno objavljene radiografske podcenitve dolžine. Zaključek. Kombinacija obeh slikovnih metod nam zagotavlja optimalne podatke o anatomiji zožitve sečnice. Iz naših rezultatov sklepamo, da je objavljena radiografska podcenitev dolžine samo napaka v oceni. (Izvleček prekinjen pri 2000 znakih).
Deskriptorji     URETHRAL STRICTURE
MEDICAL ERRORS
RECURRENCE