ArticleEuropean radiology2023
A standardized method to measure the membranous urethral length (MUL) on MRI of the prostate with high inter- and intra-observer agreement.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 16 citations in OpenAlex.
- MRI-informed urethral preservation strategy for early continence recovery after robot-assisted radical prostatectomy: a multicenter randomized controlled trial.Journal of robotic surgery · 2026Trial
- Preoperative membranous urethral length predicts quality-of-life recovery and urinary incontinence after holmium enucleation of the prostate.World journal of urology · 2026Article
- Improving membranous urethral length measurements on prostate MRI: a comparison of online training methods.European radiology · 2026Article
- Pre- and postoperative membranous urethral length on multiparametric magnetic resonance imaging predict stage-specific 0-pad continence recovery after robot-assisted radical prostatectomy.Translational andrology and urology · 2026Article
- Membranous urethral length as a predictor for urinary incontinence after holmium enucleation of the prostate for benign prostatic hyperplasia.World journal of urology · 2026Observational
- Predictive factors of immediate continence after conventional robot-assisted radical prostatectomy: a single-institution retrospective study.International journal of clinical oncology · 2025Article
- Recent developments in diagnostic ultrasound for lower urinary tract function.Journal of medical ultrasonics (2001) · 2024Review
- Membranous urethral length is the single independent predictor of urinary continence recovery at 12 months following Retzius-sparing robot-assisted radical prostatectomy.Journal of robotic surgery · 2024Article
- Proposed MRI-based membranous urethral length measurement standardization: a step to pave the way for clinical implementation?European radiology · 2024Article
- Membranous urethral length measurement on preoperative MRI to predict incontinence after radical prostatectomy: a literature review towards a proposal for measurement standardization.European radiology · 2024Review
- Automated pelvic MRI measurements associated with urinary incontinence for prostate cancer patients undergoing radical prostatectomy.European radiology experimental · 2024Article
- Article
- Prostate MRI for Improving Personalized Risk Prediction of Incontinence and Surgical Planning: The Role of Membranous Urethral Length Measurements and the Use of 3D Models.Life (Basel, Switzerland) · 2023Review
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe membranous urethral length (MUL), defined as the length between the apex and penile base as measured on preoperative prostate magnetic resonance imaging (MRI), is an important predictor for urinary incontinence after radical prostatectomy. Literature on inter- and intra - observer agreement of MUL measurement is limited. We studied the inter- and intra-observer agreement between radiologists using a well-defined method to measure the MUL on the prostate MRI.
methodsProstate cancer patients underwent a preoperative MRI and robot-assisted radical prostatectomy (RARP) at one high-volume RARP center. MUL measurement was based on well-defined landmarks on sagittal T2-weighted (anatomical) images. Three radiologists independently performed MUL measurements retrospectively in 106 patients blinded to themselves, to each other, and to clinical outcomes. The inter- and intra-observer agreement of MUL measurement between the radiologists were calculated, expressed as intra-class correlation coefficient (ICC).
resultsThe initial inter-observer agreement was ICC 0.63; 95% confidence interval (CI) 0.28-0.81. Radiologist 3 measured the MUL mean 3.9 mm (SD 3.3) longer than the other readers, interpreting the caudal point of the MUL (penile base) differently. After discussion on the correct anatomical definition, radiologist 3 re-assessed all scans, which resulted in a high inter-observer agreement (ICC 0.84; 95% CI 0.66-0.91). After a subsequent reading by radiologists 1 and 2, the intra-observer agreements were ICC 0.93; 95% CI 0.89-0.96, and ICC 0.98; 95% CI 0.97-0.98, respectively. Limitation is the monocenter design.
conclusionsThe MUL can be measured reliably with high agreement among radiologists. KEY POINTS: • After discussion on the correct anatomical definition, the inter- and intra - observer agreements of membranous urethral length (MUL) measurement on magnetic resonance imaging (MRI) were high. • A reproducible method to measure the MUL can improve the clinical usefulness of prediction models for urinary continence after RARP which may benefit patient counselling.
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