{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:46:26Z","timestamp":1760060786200,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Conventional imaging modalities are often inadequate for evaluating the proximal extent of anterior obliterative urethral strictures. Magnetic Resonance Imaging (MRI), with its superior soft tissue resolution, provides detailed anatomical insights and significantly contributes to surgical planning in such cases. Methods: Four male patients aged 26\u201363 years with anterior obliterative urethral strictures were evaluated using MRI in addition to conventional imaging. All MRI scans were performed following a modified Joshi protocol. Clinical data, MRI findings, and surgical outcomes were retrospectively reviewed. Results: MRI successfully delineated stricture length, location, periurethral fibrosis, and proximal urethral status in all cases, correlating well with intraoperative findings. Case 1 showed a 2 cm proximal bulbar obliteration, excised with end-to-end anastomosis. Case 2 had a 2.5 cm distal bulbar stricture, managed similarly. Case 3 revealed multi-segmental strictures, treated with a combination of anastomosis, graft, and Kulkarni urethroplasty. Case 4 demonstrated a rare 9 cm distal penile obliteration with preserved proximal urethra, treated with anastomotic repair. MRI provided critical anatomical detail for surgical decision-making. Conclusions: MRI is a valuable imaging modality for the evaluation of anterior obliterative urethral strictures, particularly when the proximal extent of the stricture cannot be visualized with conventional imaging techniques. In our case series, MRI enabled precise delineation of the stricture length and surrounding anatomical structures, which was critical for selecting the most appropriate surgical approach.<\/jats:p>","DOI":"10.3390\/diagnostics15192415","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T08:09:42Z","timestamp":1758614982000},"page":"2415","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Magnetic Resonance Imaging in Preoperative Evaluation of Anterior Obliterative Urethral Strictures"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5558-327X","authenticated-orcid":false,"given":"Kursat","family":"Kucuker","sequence":"first","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duran","family":"Duzgun","sequence":"additional","affiliation":[{"name":"Department of Urology, K\u00fctahya City Hospital, 43050 K\u00fctahya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1363-8360","authenticated-orcid":false,"given":"Burak","family":"Saglam","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6973-4107","authenticated-orcid":false,"given":"Ilker","family":"Gokcedag","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Kirdar","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuf","family":"Ozlulerden","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinan","family":"Celen","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8597-2081","authenticated-orcid":false,"given":"Mesut Berkan","family":"Duran","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7544-5731","authenticated-orcid":false,"given":"Ahmet Baki","family":"Yagci","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zafer","family":"Aybek","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Pamukkale University, 20160 Denizli, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1016\/j.juro.2007.01.041","article-title":"Male urethral stricture disease","volume":"177","author":"Santucci","year":"2007","journal-title":"J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.urology.2020.03.072","article-title":"Development and Validation of A Male Anterior Urethral Stricture Classification System","volume":"143","author":"Erickson","year":"2020","journal-title":"Urology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"134","DOI":"10.5152\/dir.2020.19515","article-title":"MRI in patients with urethral stricture: A systematic review","volume":"27","author":"Frankiewicz","year":"2021","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/iju.14779","article-title":"Role of magnetic resonance imaging in the management of male pelvic fracture urethral injury","volume":"29","author":"Horiguchi","year":"2022","journal-title":"Int. J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.urology.2019.09.036","article-title":"Magnetic Resonance Imaging Findings of Traumatic Bulbar Urethral Stricture Help Estimate Repair Complexity","volume":"135","author":"Horiguchi","year":"2020","journal-title":"Urology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/iju.15679","article-title":"Surgical and patient-reported outcomes of staged urethroplasty for anterior urethral strictures: A comprehensive analysis","volume":"32","author":"Minami","year":"2025","journal-title":"Int. J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/j.urology.2013.09.011","article-title":"SIU\/ICUD Consultation on Urethral Strictures: Evaluation and follow-up","volume":"83","author":"Angermeier","year":"2014","journal-title":"Urology"},{"key":"ref_8","first-page":"429","article-title":"Is ascending urethrogram mandatory for all urethral strictures?","volume":"58","author":"Mahmud","year":"2008","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s00330-003-1929-1","article-title":"Comparison of radiographic and sonographic urethrography for assessing urethral strictures","volume":"14","year":"2004","journal-title":"Eur. Radiol."},{"key":"ref_10","first-page":"2","article-title":"Imaging of urethral stricture disease","volume":"4","author":"Maciejewski","year":"2015","journal-title":"Transl. Androl. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.juro.2009.06.027","article-title":"Stricture recurrence after urethroplasty: A systematic review","volume":"182","author":"Meeks","year":"2009","journal-title":"J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.juro.2009.10.016","article-title":"Magnetic resonance urethrography to assess obliterative posterior uret hral stricture: Comparison to conventional retrograde urethrography with voiding cystourethrography","volume":"183","author":"Oh","year":"2010","journal-title":"J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Martins, F.E., Kulkarni, S.B., and K\u00f6hler, T.S. (2020). Predictors of Urethral Stricture Recurrence After Urethroplasty. Textbook of Male Genitourethral Reconstruction, Springer International Publishing.","DOI":"10.1007\/978-3-030-21447-0"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.5152\/tud.2020.20472","article-title":"Magnetic resonance imaging procedure for pelvic fracture urethral injuries and recto urethral fistulas: A simplified protocol","volume":"47","author":"Joshi","year":"2021","journal-title":"Turk. J. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1038\/nrurol.2013.275","article-title":"Male urethral strictures and their management","volume":"11","author":"Hampson","year":"2014","journal-title":"Nat. Rev. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1111\/iju.15026","article-title":"IJU this issue","volume":"29","author":"Shinohara","year":"2022","journal-title":"Int. J. Urol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1067\/j.cpradiol.2018.12.004","article-title":"MRI of the Penis: Indications, Anatomy, and Pathology","volume":"49","author":"Tu","year":"2020","journal-title":"Curr. Probl. Diagn. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1007\/s00345-022-03973-w","article-title":"Does a tailored magnetic resonance imaging technique affect the surgic al planning and outcomes for different cystic urethral and periurethra l swellings in females? Seven years tertiary center experience","volume":"40","author":"Mahfouz","year":"2022","journal-title":"World J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.euros.2021.03.004","article-title":"Accuracy of Prostate Magnetic Resonance Imaging: Reader Experience Matters","volume":"27","author":"Kang","year":"2021","journal-title":"Eur. Urol. Open Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1038\/nrurol.2010.95","article-title":"Imaging: MRI in the diagnosis of urethral diverticulum: Discrepancies between imaging and surgical findings","volume":"7","author":"Warde","year":"2010","journal-title":"Nat. Rev. Urol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e70172","DOI":"10.1002\/hsr2.70172","article-title":"Optimizing Multiparametric MRI Protocols for Prostate Cancer Detection: A Comprehensive Assessment Aligned with PI-RADS Guidelines","volume":"7","author":"Jamshidi","year":"2024","journal-title":"Health Sci. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.eururo.2021.05.032","article-title":"European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males","volume":"80","author":"Osman","year":"2021","journal-title":"Eur. Urol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.9790\/0853-1603054146","article-title":"Value of MR Urethrography in Comparison to Conventional Retrograde Urethrography in the Surgical Treatment of Occlusive Anterior Urethral Stricture","volume":"16","author":"Sudhakar","year":"2017","journal-title":"IOSR J. Dent. Med. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1111\/j.1464-410X.2011.10246.x","article-title":"Impact of urethral ultrasonography on decision-making in anterior urethroplasty","volume":"109","author":"Buckley","year":"2012","journal-title":"BJU Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1590\/S1677-5538.IBJU.2015.02.30","article-title":"A comparative study of ascending urethrogram and sono-urethrogram in the evaluation of stricture urethra","volume":"41","author":"Ravikumar","year":"2015","journal-title":"Int. Braz. J. Urol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e193","DOI":"10.1016\/j.ejrad.2009.06.008","article-title":"MR urethrogram versus combined retrograde urethrogram and sonourethrography in diagnosis of urethral stricture","volume":"74","author":"Osman","year":"2010","journal-title":"Eur. J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"153","DOI":"10.12688\/f1000research.7121.1","article-title":"Evaluation and management of anterior urethral stricture disease","volume":"5","author":"Mangera","year":"2016","journal-title":"F1000Research"},{"key":"ref_28","first-page":"106","article-title":"Magnetic resonance imaging in the diagnosis of urethral stricture","volume":"16","author":"Katibov","year":"2023","journal-title":"Exp. Clin. Urol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/19\/2415\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:47:25Z","timestamp":1760035645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/19\/2415"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":28,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["diagnostics15192415"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15192415","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,9,23]]}}}