Urethral Strictures

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The urethra is the tube that connects the bladder to the outside of body and through which urine passes. Urethral stricture, or urethral stenosis, occurs when certain benign (noncancerous) diseases of the urethra cause a narrowing of the passageway. Urethral strictures usually result from either an injury to the urethra or a viral or bacterial infection.

Symptoms of Urethral Strictures
Urethral stricture or stenosis can cause one or more of the following symptoms:
  • Blood in the semen
  • Bloody or dark urine
  • Decreased urine output
  • Difficulty urinating
  • Discharge from the urethra
  • Frequent or urgent urination
  • Inability to urinate
  • Incontinence
  • Painful urination
  • Pain in the lower abdomen
  • Pelvic pain
  • Slow urine stream (may develop suddenly or gradually)
  • Spraying of urine stream
  • Swelling of the penis

Diagnosing Urethral Strictures
If you are experiencing symptoms and your doctor suspects a urethral stricture, you may need to undergo a cystoscopy . In this procedure, a thin tube with a camera attached is inserted into your urethra to look for a stricture. A special X-ray examination called a retrograde urethrogram is often required to better evaluate the site and length of the stricture.
Treating Urethral Strictures
When diagnosed with a urethral stricture, your doctor may be able to treat the problem by dilating the urethra in a cystoscopy procedure. Under local anesthesia, a thin instrument is inserted into the urethra to stretch it. Another option is for the urologist to make a cut in the stricture and allow easier passage of urine; this is called a direct visual urethrotomy.
If dilation or incision is not effective, or if the urethral stricture is too dense or long, you may need urethral reconstruction (also called urethroplasty). There are two types of surgical urethral reconstruction:
  • With use of the anastomotic technique , the surgeon removes the narrowed section of the urethra and reattaches the two normal ends.
  • In a tissue transfer procedure , the surgeon grafts tissue from another part of the body (often the inside of the cheek or bladder) to enlarge the narrowed section and restore it to normal width.

After urethral reconstruction surgery, most patients stay in the hospital for several days. Pain or soreness in the penis or scrotum may occur, as well as soreness in the mouth if tissue from inside your cheek was used for the graft.

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