Urethral Stricture

Urethral stricture is an outcome of sclerosis of urethra.

Urethra is a tube that carries urine from the urinary bladder to outside. This restricts the flow of urine from the bladder causing accumulation of toxic substances in the urinary system leading to infection or inflammation.

Signs and symptoms of urethral stricture include:

• slowing of urine outflow suddenly or gradually,
• urine leakage,
• spraying of urine stream,
• difficulty or pain while urination,
• blood in the urine,
• discharges in the urine,
• pain in the abdomen or pelvis,
• frequent urination or increase of urge to urinate.

The causes of urethral stricture include:

• damage caused in the endoscopic examination of urinary tract,
• long term use of catheter,
• trauma to the urethra or pelvis,
• enlargement of prostate or surgery to remove prostate gland,
• cancer of urethra or cancer of prostrate,
• sexually transmitted diseases.

The diagnosis of urethral stricture is done based on the signs and symptoms, medical history, and physical examination.

Some additional tests should be done to prove the diagnosis which include:

• Urine analysis - detecting signs of infection, blood or cancer in the urine.
• Urinary flow test - it measures the strength and amount of fluid excreted.
• Urethral ultrasound - it measure the length of stricture.
• Pelvic ultrasound - it shows presence of urine in the urinary bladder after urination.
• Pelvic MRI - it evaluates any damage done by the broken bone.
• Cystoscopy - examination of urethra and urinary bladder is done by a thin tube like device fitted with lens.
• Retrograde urethrogram - uses X-ray images to assess the urinary system.

Treatment is necessary only if urethral stricture causes problems which includes:

• Catheterization - it is insertion of a small tube to drain the urine completely.
• Antibiotic therapy - antibiotics may also be prescribed to cure the underlying infection.
• Dilation - doctor inserts a tiny wire through the urethra, larger dilators are passed through the wire to dilate the urethra.
• Urethroplasty - it includes surgical removal of narrowed section of urethra to enlarge it. Tissue from other areas can be used as grafts in this procedure.
• Endoscopic urethrotomy - in this procedure, a thin optical device is inserted through the urethra and stricture is removed with the aid of laser. It provides fast recovery.
• Implanted stent or permanent catheter - A permanent artificial tube is inserted to keep the urethra opened or a permanent catheter is inserted.

There are several risks and complications associated with urethral stricture.

Risks include:

• prostate cancer,
• cancerous process in urethra,
• genetic predisposition,
• autoimmune aggression,
• having urogenital infections.

Complications include:

• development of infections in the urinary tract,
• intoxication due to accumulation of toxins and may eventually lead to kidney failure.