Comparison of magnetic resonance imaging and conventional urethrography for accuracy of assessment of urethral stricture length: a systematic review and metaanalysis

Introduction. The use of magnetic resonance imaging (MRI) for the diagnosis of urethral stricture is a promising direction. Currently, very few studies addressing this issue are available in the international literature.

Objective. To compare MRI and retrograde urethrography in terms of accuracy of urethral stricture length assessment by conducting a systematic review and meta‑analysis.

Materials & methods. A literature search was performed in the PubMed, Scopus, and Russian Scientific Citation Index databases, without restrictions on the year of publication. Study inclusion criteria for the meta‑analysis were: (1) original research; (2) within the same study, comparison of retrograde urethrography (RUG) with or without voiding cystourethrography (VCUG) and MRI for assessment of anterior or posterior urethral stricture length, with correlation of these data against intraoperative stricture length measurements; (3) publication in a peer‑reviewed scientific journal (full‑text article). The initial search identified 312 publications, of which eight studies were included in the final analysis.

Results. The mean urethral stricture length by RUG + VCUG differed significantly from the mean intraoperative stricture length, both when comparing all eight studies (mean difference 12.6 mm) and when comparing seven studies excluding one study with a large weight (mean difference 3.8 mm). The mean urethral stricture length by MRI differed significantly from the mean intraoperative length only when comparing all eight studies (mean difference 7.73 mm), whereas no significant difference was observed when comparing seven studies excluding one study with a large weight (mean difference 0.24 mm).

Conclusion. MRI provides more accurate information on urethral stricture length compared with conventional urethrography and yields data comparable to intraoperative measurements. Therefore, MRI should be used more actively in the diagnosis of urethral stricture.

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