Urethral strictures refer to the narrowing of the urethra, which is the tube that carries urine out of the body. This condition is typically caused by scarring, which can block or narrow the urethra, making it difficult to urinate and potentially causing pain.
The symptoms of urethral strictures can include:
- Difficulty emptying the bladder
- Urinary tract infections
- Low urine stream
- Pain during urination
- Urgency to urinate
- Spraying urine stream
- Dribbling
- Bloody or dark urine
- Swelling of the penis
- Blood in semen
Diagnosis of urethral strictures
Urethral strictures are diagnosed through a combination of clinical history, physical examination, and various tests. Here are the common steps involved in the diagnosis:
Clinical History: The doctor will ask about your symptoms and your medical history.
Physical Examination: This includes a digital rectal exam to evaluate your prostate.
Urine Tests: These look for infection, blood or cancer in the urine.
Urinary Flow Test: This measures the urine flow and how strong it is.
Urethral Ultrasound: This shows how long the stricture is.
Pelvic Ultrasound: This looks at whether there’s still urine in the bladder after emptying it.
Pelvic MRI Scan: This looks at the pelvic bone to see how it’s involved with the condition.
Retrograde Urethrogram: This test uses X-ray images to look for a problem or injury of the urethra. It also shows how long the stricture is and where it is.
Cystoscopy: This uses a thin, tubelike tool that has a lens, called a cystoscope. The tool looks inside the urethra and bladder.
What are the treatments for urethral strictures?
Treatment options for urethral strictures depend on the type and severity of the condition. Here are some common treatments:
Catheterization: Putting a small tube called a catheter into the bladder to drain urine is often the first step for treating urine blockage.
Antibiotics: These are used to treat an infection if there is one.
Self-catheterization: This might be a choice for those diagnosed with a short stricture.
Dilation: This involves gradually stretching the stricture using dilators of increasing size. Newer techniques may use an inflatable balloon to widen the urethra.
Urethroplasty: This involves surgically removing the narrowed section of the urethra or making it larger. Tissues from other areas of the body, such as the skin or mouth, may be used as a graft during the process.
Endoscopic Urethrotomy: This procedure uses a thin, tubelike tool that has a lens, called a cystoscope. The cystoscope goes into the urethra. Then a tool is put through the cystoscope to remove the stricture or treat it with a laser.
Implanted Stent or Long-term Catheter: This treatment might be for people with a severe stricture who don’t want surgery. A tube, called a stent, is put into the urethra to keep it open, or a permanent catheter is put in to drain the bladder.