A urethral stricture develops in the urethra, i.e. the tube which carries urine from the urinary bladder to the exterior where it is eliminated from the body.
In a healthy individual, the urethra is wide enough for the urine to flow through freely. A stricture is the narrowing of the urethra; consequently, the flow of urine gets slightly or severely limited.
A urethral stricture develops when there is scarring in the urethra and as a result the urethra narrows. A urethral stricture restricts the urinary flow from the urinary bladder and triggers a host of medical problems in the urinary tract – inflammation or infection.
What Causes Urethral Stricture Disease?
- The most significant cause of a stricture in the urethra is inflammation of the tissue or the presence of a scar tissue. Scar tissue may develop due to various factors. Young boys who have a hypospadias surgery (i.e. surgical intervention to rectify an under-developed urethra) and men who have penile implants have a lot more risk of developing a stricture.
- A straddle injury is a very common kind of trauma which is known to cause urethral stricture. Straddle trauma occurs when you fall on a bicycle bar or get hit in the scrotum.
- Pelvic fracture, insertion of a catheter, radiation, and surgery carried out on the prostate are other important causative factors.
- Potential, but a seldom seen cause is the presence of a tumor mass situated in close proximity to the urethra.
- Untreated and neglected urinary tract infections as well as sexually transmitted infection – gonorrhea causes urethral stricture too.
Symptoms Of Urethral Stricture
A urethral stricture manifests as:
- Reduced flow of urine or decrease in the volume of urine.
- Pain and discomfort whilst urinating.
- Sudden and frequent urges to pass urine.
- Incontinence of urine, i.e. inability to control urination.
- Pain in the lower abdomen.
- Urethral discharge.
- Swelling of the penis.
- Presence of blood in the semen and / or urine.
- Urine may be very dark yellow.
- Inability to urinate.
Treatment Options For Urethral Stricture
A simple physical examination helps identify the issues which specify the presence of a urinary stricture. The health care provider will readily perceive redness and will find out if one or more areas are swollen and / or hard. Your health care provider may also order a few tests to be carried out to establish the accurate diagnosis. These include:
- Measuring the rate of urine flow.
- Evaluating the physical and chemical properties of urine.
- Cystoscopy, i.e. inserting a small tube with a camera into to observe the inside of the bladder and urethra.
- Measuring the size of the urethral opening.
- Assessment for chlamydia and gonorrhea.
Thereafter, your doctor will decide the best line of treatment for you.
- The chief line of treatment is to widen the urethra using a dilator. Your health care provider will pass a tiny wire through the urethra and in to your bladder. Over time, larger dilators will be employed to slowly increase the width of the urethra. Another non-surgical alternative is perpetual catheter placement, though this is usually done for very serious cases and it also carries certain risks like bladder irritation and U.T.I. Urine flow diversion is recommended by doctors when the above treatment options fail to work, and the flow of urine needs to be diverted and drained via a catheter in the abdomen. This is rather unusual, and is considered a last-resort technique.
- Surgery is another beneficial choice. An open urethroplasty may be carried out for longer and very severe urethral strictures. The surgery comprises of excising the afflicted tissue, followed up by reconstruction of the urethra.