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The tube transporting urine from the bladder out of the body is known as the urethra. Under normal circumstances, this tube is wide enough for urine to flow freely but in some cases, one or more section can get narrowed and restrict the flow of urine. This may be diagnosed as a urethral stricture. This length of this stricture can range from 1 cm to affecting the entire length of the urethra.
This is caused by scar tissue or inflammation of tissue in the urethra. While this is a common condition that affects men, it is rarely seen to affect women. An enlarged prostate, exposure to STDs like gonorrhoea or chlamydia, suffering from an infection that causes urethral inflammation and irritation or having had a catheter recently inserted can increase the risk of suffering from a urethral stricture. An injury or tumour located near the urethra can also cause this condition. Hence, preventing this condition is not always a possibility.
Common symptoms to look out for include:
- Inability to urinate
- Reduction in the flow of urine
- Increased urge to urinate frequently
- Pain while urinating
- Urinary incontinence
- Abdominal pain
- Swelling of the penis
- Discharge from the urethra
- Blood in the urine or semen
- Dark urine
- The bladder feeling gull even after urinating
A physical examination and tests that measure the rate of urine flow and chemical composition of the urine can help a doctor determine a diagnosis of urethral strictures. You may also need to undergo STD tests and a cystoscopy. An X-ray may also help locate the stricture. The treatment for this condition depends on the severity of the symptoms.
Non-surgical treatment for this condition involves using a dilator to widen the urethra. However, there is no guarantee the blockage will not recur at a later date. Alternatively, a permanent catheter may also be inserted.
There are two forms of surgical treatment for a urethral stricture.
- Open urethroplasty: This involves removing the infected or scar tissue and restructuring the urethra. The results of this procedure depend on the size of the blockage. It is usually advised only in cases of long, severe strictures.
- Urine flow diversion: In the case of a severe blockage and damage to the bladder, the doctor may advise rerouting the flow of urine to an abdominal opening. This process involves connecting the ureters to an incision in the abdomen with the help of part of the intestines.
- Endoscopic cutting of stricture ( D.V.I.U.): A thin tube with a camera (endoscope) is inserted into the urethra to visualize the stricture. DVIU may be repeated if the stricture recurs, however, after the third treatment or recurrence of the stricture less than three months after the procedure, repeat DVIU offers no long-term success.