GIÁ TRỊ PHỐI HỢP CỦA RUG VÀ VCUG TRONG ĐÁNH GIÁ TỔN THƯƠNG HẸP NIỆU ĐẠO: ĐỐI CHIẾU VỚI DỮ LIỆU PHẪU THUẬT

Abstract

Objectives: This study aims to evaluate the correlation between RUG/VCUG imaging findings and intraoperative findings in patients with urethral stricture, focusing on stricture location, length, number of segments, and severity. Additionally, we assess the diagnostic accuracy of these imaging modalities in predicting surgical findings. Methods: A cross-sectional descriptive retrospective study was conducted on 150 male patients diagnosed with urethral stricture who underwent both RUG and VCUG, followed by surgical treatment at Binh Dan Hospital between 2021 and 2024. Imaging results were independently assessed and compared with intraoperative findings. Statistical analysis included Chi-square tests, Cohen’s Kappa coefficient, and calculations of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: RUG/VCUG imaging showed a high concordance with surgical findings in identifying the stricture location (Kappa = 0.82; p < 0.001). The mean stricture length was 2.9 ± 1.5 cm, ranging from 0.7 cm to 6.8 cm. Regarding stricture severity: mild strictures (≥ 4 mm) were observed in 34 out of 150 cases (22.7%), moderate strictures (2–4 mm) in 95 cases (63.3%), and severe strictures (<2mm) in 21 cases (14%). The concordance rate between imaging diagnosis and surgical findings exceeded 85% for most parameters. The overall sensitivity and specificity of RUG/VCUG were 82.1% and 90.9%, respectively. The positive predictive value was 94.0%, and the negative predictive value was 74.6%. Conclusion: RUG and VCUG are effective imaging techniques for preoperative evaluation of urethral strictures. The combination of both modalities enhances diagnostic accuracy in assessing stricture characteristics and plays an important role in treatment planning. However, in complex, fibrotic, or multi-segment strictures, additional modalities such as urethroscopy or urethral ultrasound may be necessary for comprehensive assessment.