Background: The evaluation of male anterior urethral lesions has traditionally relied on retrograde urethrography, a technique that has served as the gold standard for many years. However, with the advent of sonourethrography, there arises a potential for a more efficient and possibly safer method of assessment. This study aims to explore the utility of sonourethrography in this domain and to benchmark its diagnostic performance parameters, such as sensitivity, specificity, and predictive values, against the established retrograde urethrography.

Methods: Ethical clearance was acquired for 49 male patients referred from the Department of Urology and General Surgery due to complaints related to anterior urethral abnormalities. Each patient underwent a sonourethrogram procedure using the Philips HD 15/Philips Affiniti 50G machines, followed by the conventional retrograde urethrography.

Results & Interpretation: When compared to the gold standard retrograde method, sonourethrography boasted a sensitivity of 83%, specificity of 94%, positive predictive value of 96%, and a negative predictive value of 78%. Notably, sonourethrography is quicker and simpler to administer than retrograde urethrography, eliminates the need for iodinated contrast material, and removes radiation risks. Given its three-dimensional nature and its safety for repeated use, incorporating sonourethrogram into daily medical practice offers a convenient and side-effect-free solution.

Conclusion: Sonourethrography emerges as a highly efficient, safe, and faster alternative to the conventional retrograde urethrography for assessing anterior urethral lesions. With its high sensitivity, specificity, and predictive values, coupled with its advantages such as no radiation exposure and the elimination of iodinated contrast materials, sonourethrography is poised to become a preferred choice in clinical settings. Its three-dimensional capabilities and the absence of side effects further accentuate its value, making a compelling case for its broader adoption in everyday medical practice.