What is urethral stricture?
It is the result of a process of scarring and fibrosis of the urethral mucosa that narrows the urethra. In other words, it restricts the flow of urine from the bladder.
This scarring can be located anywhere along the urethra.
Symptoms
The patient may present with several of the following symptoms:
- Difficulty initiating urination.
- Weak urinary stream.
- Burning and burning sensation in the urethra.
- Increased urge to urinate.
However, these symptoms are common to other processes such as prostate hypertrophy. For this reason, it is necessary to study each case to rule out whether it is a urethral stricture or another process.
Diagnosis
There are different procedures that allow the diagnosis of urethral stricture. However, the most commonly used, given their high level of reliability, are retrograde urethrography and cystoscopy.
Causes
Urethral stricture usually occurs after damage to the urethral mucosa causing scarring. It may be congenital or caused by previous infection or trauma.
They usually respond to this second type of cause, but a high percentage of cases occur without a clear trigger.
Among the most frequent causes that give rise to urethral stricture we find:
- Genital infections.
- Urinary catheterization.
- Trauma.
- Straddle fall.
- Sclerosing balanitis.
Treatment
There are two types of treatment for urethral stricture. The first one tries to save the obstruction by dilatation of the stricture, resection of part of the stricture with endoscopy or by placing a stent to dilate the stricture.
The second type of treatment directly treats the stricture by resecting the strictured urethral fragment or by replacing the strictured fragment with a tissue plasty from another mucosa. To do this, the urethra is widened by inserting an instrument that forces the narrowing open.
The stricture will be opened by means of the instrument passing through the urethra and using a scalpel or laser to make the incisions.
There are few cases where scar tissue re-forms after treatment.
What specialist treats it?
The urologist will be the specialist in charge of the study, diagnosis and treatment of urethral stricture.