WHAT IS A URETHRAL STRICTURE?

WHAT IS A URETHRAL STRICTURE?

A urethral stricture also called stricture urethra is a condition when a portion of the urethra-tube that carries urine out from bladder is abnormally narrowed resulting in difficulty with urination and associated problems. It persists in men mostly, rare in women.

WHAT ARE THE CAUSES OF URETHRAL STRICTURE OR STRICTURE URETHRA

1. Straddle Injury
   Usually, boys and young men are injured or experience an impact to the groin or scrotal area by a bicycle bar, a fence, being kicked or hit by a ball.However, they do not develop symptoms or any signs indicating stricture urethra until a few months or years after an injury.
2. Pelvic Bone Fracture
   
   The tear of the membranous portion of the posterior urethra is resultant of pelvic fracture. In most cases of pelvic fractures, the bulbar and membranous ends separate, and the patient is totally unable to urinate. Various causes of pelvic fractures in men include automobile and motor vehicle accidents (RTA) and crush injuries, often work-related.
3. Lichen Sclerosus (LS) or Balanitis Xerotica Obliterans (BXO)
   Men with LS or BXO have whitish discoloration of the penile skin and can develop longer strictures.
4. Hypospadias Surgery Hypospadias can be complicated with the development of stricture urethra.
5. Urologic Procedures
   In some urology surgeries followed by catheterization can cause damage to the urethra and subsequent stricture formation.
6. Prostate cancer surgery by Radiation therapy
   Complex structures can occur as a complication after prostate surgery in some cases.

WHAT ARE THE SIGNS AND SYMPTOMS OF STRICTURE URETHRA

• slow or decreased urine stream
• straining to urinate
• Feeling of incomplete bladder emptying.
• Blood in urine and semen
• pain with urinating
• unusual abdominal pain
• urethral leaking
• Urinary tract infection
• swelling of the penis due to some chronic infection
• loss of bladder control due to age or some injury

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HOW IS A URETHRAL STRICTURE DIAGNOSED?

Retrograde urethrogram RUG-proper urethral X-ray imaging done to see the length, location, and severity of the urethral stricture. RGU needs to be performed using a specific technique modified to gently provide high-resolution images to make the accurate diagnosis.

Cystoscopy is done in some cases, it is done using a flexible scope to check upon the urethra.

TREATMENT OPTIONS AVAILABLE FOR STRICTURE URETHRA

Medicines do not prove beneficial in cases of stricture urethra. Treatment options depending upon the length and location of the stricture include:

• Dilation – dilating the stricture with gradual stretching
• Urethrotomy – cutting the stricture with a laser or surgical knife using a scope
• Urethroplasty – surgical removal of the stricture with the reconstruction of urethra.

If stricture urethra is left untreated, the patient continues to have issues with urine voiding.

Urinary or testicular infections and stones could develop.

Such patients are at more risk of getting urine retention, which could lead to an enlarged bladder and kidney problems later.

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