Urethral Stricture Disease

A urethral stricture occurs when this tube becomes narrow due to scar tissue formation within it.

Urethral Stricture Disease can cause the blockage and even backflow of urine into the urinary tract leading to kidney damage.

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What is Urethral Stricture Disease?

The urethra is a tube carrying urine from the urinary bladder to outside the body. A urethral stricture occurs when this tube becomes narrow due to scar tissue formation within it.

They can cause blockage and even backflow of urine into the urinary tract leading to kidney damage.

What are the symptoms of Urethral Stricture Disease?

  • Inability to empty the bladder

  • Increased urgency and frequency to pee

  • Frequent urinary tract infections (UTIs)

  • Bladder incontinence (loss of bladder control)

  • Pain when peeing

  • Swelling of the penis or nearby structures

If left untreated urethral strictures can lead to severe urinary system side effects, such as kidney infections and stones.

Chronic urinary retention can cause the bladder to enlarge and become dysfunctional.         

What is the Treatment for Urethral Stricture Disease?

Treatment for urethral strictures depends on its location, the symptoms they produce, and the health condition of the patient.

If there are no or mild symptoms, the doctor may suggest waiting and watch to check if it heals on its own.

If a person has severe urinary retention, a special catheter called a suprapubic catheter is inserted that goes into the urinary bladder through the abdomen, above the pubic bone.


Nonsurgical Management:

The urethra is made wider using an instrument called a dilator which is a small wire that is inserted through the urethra and into the bladder to dilate or expand it.

Larger dilators will gradually increase the width of the urethra over the time it is placed.

An alternate option is a permanent urinary catheter used in severe cases. It has risks, e.g. urinary tract infection and bladder irritation.

 Surgical options include:
  • Urethral dilation

  • Internal urethrotomy

  • Urethral reconstruction

With a short stricture, urethral dilation or internal urethrotomy may be performed. 

Under general anesthesia, the urethra is stretched using a series of dilating instruments of various sizes and a cystoscope.

In a urethrotomy, a cystoscope is utilized to cut the ring of scar tissue and open the area of obstruction.

What is post surgery care to be taken?

After the procedure, a urethral catheter is placed for a period of three to five days. One may notice some blood in the urine initially after this surgery.

If dilation or urethrotomy fails and the structure returns, urethral reconstruction may be required to open the urethra. 

Sometimes, the urethra is reconstructed by removing the scar tissue and is sutured with the ends of the urethra, in a procedure called a Urethroplasty. 

If this is impossible, the urethra can be repaired using the lining of the inside of the cheek or skin flaps from the penis /scrotum.

  • Urethral strictures can reoccur, even after surgical treatment. This may require additional surgical interventions. Urethral stricture prevention is not always possible. However, there are some tips to reduce their chances:

  • If a person must insert a catheter themselves to pee, use lubrication in the form of jelly and the smallest possible catheter for the shortest time possible.

  • Use barrier protection during sexual activity to prevent the transmission of sexually transmitted diseases and infections.

  • Regularly get tested for STIs, and seek the proper treatment.

  • Take steps to avoid pelvic injuries, by wearing appropriate protective equipment while playing rough sports.

  • Urethral strictures can be troublesome for both males and females.

  • Treatments for urethral strictures range from watchful waiting to surgery. As they can recur, follow-up appointments become crucial to monitor the condition in case they come back.

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