Abstract: PURPOSE: To prospectively assess the diagnostic accuracy and clinical utility of sonourethrography (SUG) in the evaluation of anterior urethral strictures in a series of 150 patients. MATERIALS AND METHODS: This prospective observational study involved 150 male patients with suspected anterior urethral strictures. All patients underwent SUG and retrograde urethrography (RUG). Stricture characteristics, including length, location, and spongiofibrosis, were recorded and compared with intraoperative findings. Diagnostic performance was analyzed using sensitivity, specificity, receiver operating characteristic (ROC) curve, Bland-Altman agreement, multivariate logistic regression, and intraclass correlation coefficient (ICC). RESULTS: SUG demonstrated a sensitivity of 94% and specificity of 97%, with close agreement to intraoperative stricture length (mean difference 1.8 mm; P < 0.05). Spongiofibrosis was detected in 55% of cases by SUG and confirmed surgically. SUG findings influenced surgical planning in 30% of patients. The ROC curve indicated excellent diagnostic accuracy (area under the curve = 0.95). Bland-Altman analysis showed good agreement in length measurement (mean bias −1.8 mm, limits of agreement −5.2 to +1.6 mm). Logistic regression revealed stricture length and fibrosis as independent predictors for surgical plan modifications. ICC demonstrated excellent interobserver reliability (0.87). CONCLUSION: SUG is a highly effective, nonradiative imaging modality providing detailed anatomical evaluation of anterior urethral strictures, thereby guiding optimal management strategies.
Jatla Jyothi Swaroop (2026) studied this question.