Female urethra stricture

Case contributed by Dr Mostafa El-Feky

Presentation

Known patient with suspected urethral lesion

Patient Data

Age: 65 years
Gender: Female
MRI

Pelvis

Patulous proximal third urethra with concentric hypointensity of the mucosal lining of the distal two-thirds urethra averaging around 2 cm in length down till the external urethral meatus which shows subtle edema of mostly inflammatory changes. Still no associated focal lesions identified. Features in favor of distal urethral stricture, likely post-inflammatory.

This is associated with backpressure changes manifested as increased urinary bladder reservoir with thick irregular wall reflecting hypertrophic trabeculae and bilateral hydroureter, reflecting element of outlet obstruction.

No focal urethral wall rent, diverticulum or fistula identified. No peri-, para-urethral cystic or solid lesions noted.

Minimal free pelvic and pouch of Douglas collection is also noted.

MRI

Annotated images

Annotated images demonstrate:

  • the length of the distal urethral stricture (~2 cm)
  • proximal funnelling of the bladder neck (proximal circle in sagittal image)
  • external urethral meatus which shows subtle edema of mostly inflammatory changes (distal circle in coronal image).

Case Discussion

Imaging features are in favor of distal female urethral stricture with secondary urinary bladder changes of chronic outlet obstruction and bilateral hydroureter.

Case courtesy of Dr Heba Hassan, Professor of radiology, Alexandria University, Egypt.

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Case information

rID: 71882
Published: 22nd Dec 2019
Last edited: 24th Dec 2019
System: Urogenital
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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