Endoscopy and Radiology for Lower Urinary Tract D

ysfunction

Hann-Chorng Kuo

Department of Urology

Buddhist Tzu Chi General Hospital

Lower Urinary Tract

Urinary bladder

Ureteral orifices

Trigone

Bladder neck

Prostate and prostatic urethra

Urethral sphincter

Urethra (posterior, bulbous, anterior)

Bladder wall in Cystoscopy

Smooth bladder wall

Trabeculated bladder wall

Diverticulum

Pseudodiverticulum

Bladder tumor

External compression

Smooth Bladder Wall

Trabeculation of Bladder Wall

Bladder Tumor

Bladder mucosa

Normal mucosa and vasculature

Hyperemia

Ischemia

Hemorrhagic cystitis

Cystitis cystica

Pseudomembranous trigonitis

Granulomatous cystitis

Normal Mucosal Vasculature

Hyperemia and Inflammation

Hemorrhagic cystitis

Cystitis Cystica

Pseudomembranous Trigonitis

Granulomatous Cystitis

Tuberculosis Cystitis

Prostatic enlargement

Benign prostatic enlargement

Prostatic cancer

Bladder Neck Obstruction

Urethral Stricture

Bladder neck contracture

Membranous urethral stricture

Anterior urethral stricture

Anterior urethral valve

Meatal stenosis

Urethral Stricture

Ureteral Orifice

Normal cone shape

Horseshoe shape

Stadium shape

Golf hole shape

Short submucosal ureteral tunnel

Ureteral Orifice

Chronic Inflammation of Female Bladder Neck

Female Urethral Incompetence

Bladder neck incompetence

Urethral incompetence

Interstitial Cystitis

Painful Bladder Syndrome

Bladder Stone

Bladder musculature

Uroradiology in Lower Urinary Tract Dysfunction

Intravenous pyelography (IVP)

Retrograde pyelography

Cystography

Voiding cystourethrography

Retrograde urethrography

Beaded chain cystourethrograph

Magnetic resonance image (MRI)

Intravenous pyelography inBenign Prostatic Hyperplasia

Inravenous Pyelography in High Grade Cystocele

Retrograde Pyelography inUreteral stricture

Voiding Cystourethrography

Bladder neck dysfunction

Prostatic obstruction

Urethral stricture

Anterior urethral valve

Vesicoureteral reflux

Bladder diverticulum

Cystography on Straining

Urethral Incompetence

Bladder Base IndentationProstate Enlargement

Voiding CystourethrographyProstatic Obstruction

Voiding Cystourethrography inDESD and after Sphincterotomy

Voiding CystourethrographyAnterior urethral valve

Voiding CystourethrographyDysfunctional voiding

Voiding CystourethrographyUrethral meatal stricture

Transrectal sonography

Prostatic configuration

Urethral stricture

Bladder neck incompetence

Bladder base hypermobility

Intravesical pathology

Prostate Configuration

Prostatic urethra

Transition zone of prostate

Seminal vesicle

Ejaculatory duct

Peripheral zone of prostate

Bladder neck

Transrectal sonography of the Prostate, Seminal vesicle, Urethra

Prostatic Enlargement

Transition Zone Index (TZI)

Transition zone vol/ total prostate vol

A TZI of <0.3 indicates low possibility of prostatic obstruction, a TZI of >0.5 indicates highly suspicious prostatic obstruction

TZI correlates poorly with total prostatic volume

Measurement of TZI

Female Urethral Structure

Female Urethra in SUI

Hypermobility of Bladder Base

Beaded-Chain Cystourethrography

MRI of Cystocele

MRI of Large Cystocele & Enterocele

MRI of Rectocele

MRI of Uterine Prolapse