Urethral Stricture - An Overview

Introduction

A urethral stricture is a condition that causes scarring, which narrows the tube that lets urine out of the body, the urethra. This can result in an infection of the urinary tract. In some rare cases, urethral stricture requires immediate medical care.

What Is Meant by Urethral Stricture?

Urethral stricture is a condition which results in narrowing of the urethra. Urethra is a tube that transfers the urine from the bladder through the penis to the outside of the urethral meatus, which is a small opening in the penis which lets out urine. Most of the men affected by this condition will experience difficulty during urination, and there will be a reduced urinary stream. This results in pushing or straining to get the urine out in the long run. In some men, this condition can cause symptoms quickly and suddenly and may require immediate medical care.

What Are the Causative Factors of Urethral Stricture?

Urethral stricture is usually caused due to scarring of the urethra, which can occur due to

• Some medical procedures involve inserting a medical tool, such as an endoscope, into the urethra, which can cause scarring.

• A catheter is inserted into the urethra to drain the bladder.

• Cause of trauma or injury in the urethra or pelvis.

• Presence of enlarged prostate or surgery performed to reduce or eliminate enlarged prostate.

• Cancer which affects the urethra or the prostate.

• Sexually transmitted condition or infection.

• Scarring can be caused by radiation therapy.

• Urethral stricture can be caused by lichen sclerosis, a skin condition characterized by patchy, discolored, and thin skin that affects the genital region.

In some cases, the injury or inflammation can be caused much before the symptoms of the urethral stricture occur. In contrast, in some conditions, the urethral stricture occurs immediately after the injury.

What Are the Symptoms Associated With Urethral Stricture?

The most common symptom related to this condition is the weakening of the urethral system. Other symptoms include:

• Straining to pass urine.

• Pain or discomfort during urination.

• UTI (urinary tract infection).

• Prostatitis is a condition of the prostate gland which is related to infection and inflammation.

• The bladder does not get emptied.

• Spraying urine.

• Passing urine more frequently or having the sensation to pass the urine very often.

What Is Meant by Urinary Retention?

Some men who are affected by severe urethral stricture will be unable to urinate. This condition is called urinary retention, and it requires immediate attention. Poor urine drainage can also cause renal failure. The urethral stricture can also be caused by inflammation in the prostate, as the urethra is surrounded by the prostate, which is present just below the bladder.

How Is the Urethral Stricture Condition Diagnosed?

Non-invasive testing is usually done, which helps to identify the problems related to emptying the bladder but will not help find a stricture. The rate at which a person urinates can be measured using a collection device. Slow flow of urine can be caused due to blockage in the urethra or a weak bladder. The amount of urine left in the bladder after urinating can be measured using an ultrasound scan of the bladder. Usually, no urine will be left out in the bladder after urinating, but some urine will be present in case of stricture. With the help of non-invasive testing, the doctor cannot diagnose whether the condition is caused by stricture, weakened bladder, enlarged prostate, or any other issue.

If the doctor suspects a urethral stricture, an imaging procedure will be recommended. One such procedure is:

• Retrograde Urethrogram: This is an X-ray where a contrast material is splashed into the opening of the penis. This contrast material helps to find the length and location of the stricture. The person will ask to urinate after the bladder is full so the structure will be located during the voiding process.

• Cystoscopy: In this procedure, a small camera which is flexible called the cystoscopy is inserted inside the penis. This helps the doctor visualize the inside of the urethra. It is usually performed in a clinical setup and hardly takes five to ten minutes. Before inserting the cystoscopy, a numbing gel will be applied inside the urethra, reducing the discomfort caused during the cystoscopy.

How Is Urethral Stricture Condition Managed?

The treatment options for urethral stricture will be decided with the help of the imaging [rocedure. The treatment options include:

• Urethral Dilation: The urethra is a tube that carries urine out of the body. This procedure stretches the sides of the urethra.

• Internal Urethrotomy: This is a surgical procedure in which a surgical knife or urethrotomy is passed through the cystoscope to widen a narrowed urethra.

• Urethral Reconstruction: It is a reconstruction procedure that is done after trauma caused to the urethra or after the treatment done for prostate cancer.

In case of short strictures, urethral dilation and internal urethrotomy will be performed initially. The most common disadvantage of these procedures is that the structure can reoccur. If these procedures fail or if the stricture reoccurs, a urethral reconstruction procedure will be performed to achieve the desired results.

When Should a Person Consult With the Doctor?

If a person experiences painful urination or finds it hard to empty the bladder, then they should consult the doctor. This can be caused by urethral stricture or other conditions, such as kidney stones or an enlarged prostate. It is important to treat the urethral stricture condition immediately, as if the urine backs up, it can enhance the risk of urinary tract infection.

How Can Urethral Stricture Be Prevented?

This condition can be prevented by avoiding any cause of injury to the pelvic region. Preventing the occurrence of infection can also help to prevent this condition.

Conclusion

Urethral stricture is a condition that causes painful urination due to the narrowing of the urethra caused due to injury or inflammation. The outcome of this condition is positive and treatable. Urethral stricture needs to be treated on time. If not, it can enhance the risk of urinary tract infection.