Imaging of the male urethra in the pediatric age. Anatomical study and review of the main congenital pathologies

Congress:

ECR 2018

Poster Number:

C-2471

Type:

Educational Exhibit

Keywords:

Genetic defects, Congenital, Technical aspects, Normal variants, Cystography / Uretrography, Fluoroscopy, Urinary Tract / Bladder, Paediatric

Authors:

J. Mesa Quesada, J. Vicente Rueda, L. Izquierdo Palomares, R. Muñoz; Cordoba/ES

DOI:

10.1594/ecr2018/C-2471

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2471

Fig. 3: Voiding cystourethrography (VCUG) technique.

Fig. 1: A. Male urethra anatomy. B. Male urethra radiological anatomy.

Fig. 2: Material needed to perform the urethra study.

Fig. 5: Posterior urethral valve. Newborn with dilation of the urinary tract (US:...

Fig. 8: Diverticulum of the anterior urethra. VCUG

Learning objectives

Describe the main imaging techniques for the study of the male urethra in childhood (Voiding Cystourethrography -VCUG- and retrograde urethrography). Show the normal anatomy and the radiological findings of the most prevalent congenital pathologies in our center.

Background

Congenital anomalies of the male urethra are frequent and there are numerous anatomical variants. During the complex urethral development, alterations may occur in isolation or associated with other malformative processes of the genitourinary or digestive system. Voiding Cystourethrography (VCUG) and retrograde urethrography are considered the techniques of choice for the diagnosis of the pathology of the urethra in childhood.

Findings and procedure details

1.- URETHRAL ANATOMY (Fig. 1) Male urethra is divided into 2 portions: anterior and posterior urethra. The anterior urethra extends from the external meatus to the inferior edge of the urogenital diaphragm. It is conventionally divided into the penile and bulbous urethras at the penoscrotal junction. The penile portion terminates in the glans penis to form the fossa navicularis. The posterior urethra is divided into the prostatic and membranous urethras.The prostatic urethra passes through the prostate slightly anterior to midline. The membranous urethra begins at...

Conclusion

Despite the spectacular development of radiology in the last decades, retrograde urethrography and VUG remain the reference techniques to study the male urethra in childhood A deep knowledge of the technique and the urethral anatomy, anatomical variants and congenital abnormalities is necessary, with the aim of avoiding erroneous diagnoses that cause delays in treatment or an overdiagnosis that can subject these patients to unnecessary interventions.

Personal information

References

1. Levin T, Han B, Little B. Congenital anomalies of the male urethra. Pediatric Radiology. 2007;37(9):851-862. 2. Kawashima A, Sandler C, Wasserman N, LeRoy A, King B, Goldman S. Imaging of Urethral Disease: A Pictorial Review. RadioGraphics. 2004;24(suppl_1):S195-S216. 3. Pichler R, Fritsch H, Skradski V, Horninger W, Schlenck B, Rehder P et al. Diagnosis and Management of Pediatric Urethral Injuries. Urologia Internationalis. 2012;89(2):136-142. 4. Jana M, Gupta A, Prasad K, Goel S, Tambade V, Sinha U. Pictorial essay: Congenital anomalies of male urethra in children....