A 35-year-old man presents to the urology clinic with symptoms of decreased urine flow, difficulty starting urination, and a sensation of incomplete bladder emptying. The urologist suspects a urethral stricture and plans to confirm the diagnosis.
What is the investigation of choice for diagnosing a urethral stricture?
A. Urine culture
B. Intravenous pyelography
C. X-ray KUB
D. Ultrasound
E. Urethrogram
Answer:
The Correct Answer is: E. Urethrogram
Explanation:
Urethrogram (E):
– A urethrogram, specifically a retrograde urethrogram (RUG), is the investigation of choice for diagnosing urethral strictures. This imaging test involves the injection of contrast material into the urethra followed by X-ray imaging to visualize the urethra and identify any areas of narrowing or blockage.
– A RUG provides detailed information about the location, length, and severity of the stricture, which is essential for planning treatment.
Explanation of Incorrect Options:
Urine culture (A):
– A urine culture is useful for diagnosing urinary tract infections and assessing the presence of bacteria in the urine, but it does not provide information about urethral strictures.
Intravenous pyelography (B):
– Intravenous pyelography (IVP) is an imaging test used to evaluate the kidneys, ureters, and bladder by injecting contrast dye into the bloodstream. It is not the primary test for diagnosing urethral strictures.
X-ray KUB (C):
– An X-ray of the kidneys, ureters, and bladder (KUB) can detect stones and some structural abnormalities, but it does not provide the detailed imaging needed to diagnose urethral strictures.
Ultrasound (D):
– Ultrasound can be useful for evaluating the bladder and kidneys and for identifying complications such as hydronephrosis due to severe stricture. However, it does not provide detailed images of the urethra needed to diagnose strictures.
In conclusion, the investigation of choice for diagnosing a urethral stricture is a urethrogram, making option E the correct answer.