In penile and urethral cancers, imaging has come to play a crucial role in enhancing the precision of clinical staging and facilitating optimal surgical planning. Over the years, great improvements have occurred in imaging. High-resolution magnetic resonance imaging (MRI) now represents the gold standard for evaluating the primary tumor and its local extension. Lymphotropic nanoparticle-enhanced MRI, dynamic sentinel lymph node biopsy, and ultrasonography with fine-needle aspiration seem to be the superior modalities for detecting malignant regional lymph nodes. Positron emission tomography combined with computed tomography has shown great promise as a whole body screen for the detection of distant metastases. Ultimately, the ability of imaging to augment clinical evaluation and enhance the accuracy of staging penile and urethral cancers will translate into improved surgical decision making and overall superior patient outcomes.
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