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Urethral Stricture : Definition, Causes, Symptoms, Diagnosis and Treatment

Saturday, July 28th 2012. | Disease, Uterine system

Urethral Stricture Definition

The urethra begins at the lower end of the bladder and leads to the glans penis in men and in the vagina in women.

In both sexes, it can eliminate the urine in humans, it has more functions to transmit sperm. In women, the urethra is much shorter (4 cm) than in men (approx. 20 cm). For this reason, women are more at risk of bladder infections because the bacteria reach more easily and quickly the bladder.

The urethral stricture (narrowing of the urethra) is a benign disease. Its causes vary widely.

Causes

Often, the causes of urethral stricture are unknown.

Common causes :

  • Urinary tract infection (eg. Gonorrhea).
  • Infection of the prepuce (foreskin)
  • Tumors of the urethra
  • Accidents, especially serious injuries in the pelvic region
  • Manipulation techniques such as catheterization, endoscopy, certain sexual practices with foreign bodies: trauma caused can lead to scar formation and hence to narrowing of the urethra.
  • Following radical surgery for prostate or other operations on the urinary tract.
urethral-stricture

Urethral Stricture (img : thanks to recommendpills.com)

Disorders (symptoms)

  • Difficulties with urination, up to urinary retention = medical emergency
  • Urinary stream very end, and interrupted spiral; drops post-micturition
  • Presence of residual urine after the obstacle to the flow of urine; result: cystitis
  • Burning sensation during urination
  • Blood in urine

Examinations (diagnosis)

  • History taking into account the patient’s symptoms; questioning the history of infections and trauma.
  • Urinalysis
  • Ultrasound: detects the presence of residual urine and to determine the status of the bladder.
  • Radiography with contrast (urethrogram).
  • Endoscopy of the urethra (urethroscopy)

Urethral Stricture Treatment Options

Infection should be an appropriate drug therapy. Generally, it is necessary to consult a specialist (urologist) for treatment.

Urethral Stricture Surgery Treatment

Urethral incision : under local or general anesthesia, an optical instrument is introduced into the urethra and the stenosis is dilated by means of a blade or a laser probe. Then, a catheter is placed for a few days. In most cases of urethral stricture unique and simple, this treatment is sufficient and no further action is required.

Open surgery:

In case of recurrence or stenosis extended an open operation is often unavoidable. The stenotic portion was resected through an incision in the penis and is covered by new tissue (usually taken from the foreskin or buccal mucosa). After surgery, a urinary catheter is placed until healing, for approx 2 weeks.

Tumors: tumors can completely obstruct the urethra. Treatment depends on the type of tumor.

Urethral Stricture Possible Complications

In general, surgical procedures are carried out without complications and are not subject to either urinary incontinence or an impotence. In rare cases, the operation must be repeated.

In case of urethral stricture and long-standing untreated, weakened bladder muscles can occur. In this case, a distended bladder, the formation of diverticula in the bladder or bladder stones may ensue.

Other effects : urinary tract infections, inflammation of the epididymis (epididymitis), hydronephrosis, chronic renal insuffisane with reduced kidney size.

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