Urethra Diseases Diagnosis and Tests

While less common for standard strictures, advanced imaging plays a specific role.

• Urethral Ultrasound: In men, this can be used to measure the depth of spongiofibrosis (scarring) surrounding the stricture. Knowing how deep the scar extends helps determine whether a simple cut (urethrotomy) will suffice or whether open surgery is needed. In women, ultrasound is the primary modality for diagnosing urethral diverticula, as it visualizes the fluid-filled sac adjacent to the urethra.
• MRI: Magnetic Resonance Imaging is utilized for complex pelvic trauma, particularly distraction injuries where the urethra has been sheared off. It helps visualize the distance between the disconnected urethral ends and the extent of pelvic scar tissue, aiding in planning complex reconstructive surgery.

Laboratory Evaluation

While imaging defines the anatomy, laboratory tests determine the biological environment.

• Urinalysis and Culture: Mandatory to rule out active infection. Operating on a urethra with infected urine can lead to severe sepsis.
• STI Panel: In cases of urethritis, nucleic acid amplification tests (NAAT) on urine or urethral swabs are used to identify Chlamydia, Gonorrhea, Mycoplasma, or Trichomonas. Identifying the specific pathogen is crucial for targeted antibiotic therapy.