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Overview

Urethral Stricture: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Urethra is a tube that carries urine from the bladder so as to expel it. The urethra normally remains wide enough so as to allow the urine to seamlessly flow through it. Urethral stricture is a condition when the flow of urine is impeded because of the narrowing of the urethra. Mostly men are affected by this ailment.

Urethral stricture is mainly caused due to the inflammation of the tissues or because of the presence of scar tissues. Scar tissues may develop due to a number of reasons. If a man has undergone endoscopy whereby an instrument is inserted into the urethra, he is at risk of developing scar tissues. Other causes are cancer of urethra or prostate, radiation therapy, sexually transmitted infections, trauma or injury to the pelvis or urethra, long-term use of catheter to drain the urinary bladder and an enlarged prostate. Men who have had suffered from sexually transmitted infections, had a recent catheter placement, had urethritis due to infection and an enlarged prostate are at the highest risk of developing this condition.

The treatment for urethral stricture requires the widening of the urethra. It can be done non-surgically by means of a dilator. Surgical procedure in the form of open urethroplasty can also be done to treat this condition. A complete urinary diversion procedure may also be done.

How is the treatment done?

The non-surgical mode of treatment requires the use of medical instrument called a dilator to make the urethra wider. This is mostly a simple procedure that does not require a patient to get admitted to any hospital as it is an outpatient procedure. A small wire is passed through the urethra and into the bladder. This process helps to dilate the urethra. The width of the urethra gradually increases with the continued use of the large dilators. Another non-surgical method that is used to treat severe cases of urethral stricture is the permanent urinary catheter replacement.

There are no medications to treat urethral stricture. This condition does not go away easily and surgery is generally recommended for people with urethral symptomatic strictures. Direct vision internal urethrotomy is an endoscopic procedure whereby an endoscope is inserted into the urethra to see the stricture. Then a tiny knife is passed through the endoscope to cut the stricture and widen the urethra. Open urethroplasty reconstructs the urethra after the removal of the tissues. Another procedure to treat this condition is the urinary diversion procedure. The flow of the urine is permanently rerouted to an opening in the abdomen. Part of the intestine is used to connect the ureters to the opening. This procedure is generally done when if the bladder is severely damaged or if it is to be removed.

Who is eligible for the treatment? (When is the treatment done?)

A person suffering from urethral stricture may experience a number of symptoms like decreased urine steam, difficulty or experience of pain during urinating, frequent urge for urination, incomplete emptying the bladder and urinary tract infection. A person experiencing some or most of these symptoms is eligible for treatment. A doctor will review a patient’s medical history, perform a thorough physical examination and even one or more tests on a patient to determine whether he is suffering from the condition. A person will be eligible after he has been diagnosed by a doctor.

Who is not eligible for the treatment?

People who do not have severe urethral strictures are generally not eligible for treatment. A person not experiencing any of the symptoms associated with urethral stricture is not eligible for treatment. Some of the tests that may help a doctor to understand whether a person has urethral stricture or not are measuring of rate of flow of urine, cystoscopy, measuring the size of the urethral opening, analyzing the physical and chemical properties of urine to find out if there is bacteria and tests for Chlamydia and gonorrhea. A person will not be eligible for treatment if the doctor does not diagnose him after performing these tests.

Are there any side effects?

Urethral dilation can make the stricture worse over a certain period of time. The side-effects of direct vision internal urethrotomy are pain, bleeding, erectile dysfunction, urinary tract infection and even recurrent stricture. The risks associated with open urethroplasty are infection, bleeding, recurrent stricture, pain and fistula and dribbling after urination. Urinary diversion surgery has its fair share of complications as well.

What are the post-treatment guidelines?

A person who has undergone surgery to treat urethral stricture will require a few weeks time before he can resume his normal physical activities. It is always useful to follow the doctor’s advice. After a surgery, a catheter is left for about a week. In some other cases, a suprapubic tube is also left in addition to the catheter.

How long does it take to recover?

The time required for a person to recover from a surgery for urethral stricture depends on a number of factors like which procedure has been performed, how long the catheter has been kept in place, the overall health status of the patient and even on the preference of the physician. Procedures like urethroplasty require a longer recovery period while other procedures like internal urethroplasty and dilation are generally outpatient procedures.

What is the price of the treatment in India?

The cost of urethroplasty surgery in India can vary in between Rs 1,90,000 to Rs 3,22,000. Repeat urethrotomy and dilation to treat urinary stricture can cost more than Rs 5 lakhs.

Are the results of the treatment permanent?

Urethral stricture can be treated successfully if a doctor can identify the most appropriate initial treatment strategy. A proper treatment strategy will help to reduce the recurrence of this condition. A person who has undergone treatment should take extra care while using catheters and instrumentation so as to avoid developing this condition again. However, the results are not permanent as a person may develop this aiment as a result of some injury or disease.

What are the alternatives to the treatment?

Clematis is a homeopathic treatment that helps to cure urethral stricture in the initial stages. Another homoeopathic medicine used to treat people who have difficulty in passing urine is the Chimaphila. Other homoeopathic medications that help to deal with the symptoms of urethral stricture are cantharis, thiosinaminum, conium, arnica and others.

Safety: Medium Effectiveness: High Timeliness: Medium Relative Risk: Low Side Effects: Medium Time For Recovery: Low Price Range:

Rs 190000 - RS 500000

Popular Health Tips

Frequent Urination & Burning Sensation In Women - Why Does It Happen?

DGO , MBBS
Gynaecologist, Pune
Frequent Urination & Burning Sensation In Women - Why Does It Happen?

Burning urination or painful urination is also called dysuria, and it is one of the most common complaints amongst women. Another common problem is frequent urination. What are the causes of these two conditions? Are they in fact related? 

Frequent urination, in simple terms, is also sometimes called overactive bladder and it is the need to urinate more than you normally would. This can cause loss of bladder control too. You may feel extremely full even after using the toilet and the feeling is extremely uncomfortable. Medical practitioners bracket urinating every two hours or more as frequent urination.

Some of the underlying causes are

  1. A urinary tract infection or UTI is the most common cause of frequent urination. UTIs happen when bacteria enters your urinary bladder through the urethra. Men also get UTIs, but it is less common than women as the ladies have shorter urethras. This means that bacteria have less distance to travel before they can infect the urinary tract causing UTIs. UTIs in women can be prevented by proper wiping after using the toilet, which will protect the urethra from E.coli bacteria. Proper hygiene also is a deterrent, especially after intercourse.
  2. Medical conditions affecting muscles, nerves, and tissues. Weakening of nerves due to hernias in the lower back etc. can also cause an overactive bladder.
  3. Oestrogen deficiency caused due to menopause can cause an overactive bladder and a woman finds it difficult to hold the urine for long.
  4. Obesity can also place extra pressure on the bladder.

Burning sensation while urinating 

Common reasons behind it

  1. Frequent urination does not point to any gynaecological issues but burning urination is a common symptom of sexually transmitted diseases or STDs like Chlamydia and Gonorrhea which cause symptoms like pain when urinating and vaginal discharge. Burning urination usually occurs after intercourse when sexually transmitted infections are present.
  2. Burning while urination can also be caused due to UTIs and it is often accompanied by other symptoms of UTIs like painful urination or dysuria or blood in the urine.
  3. Kidney stones are solid masses of crystalized calcium or other materials that start in the kidneys but can pass through the urinary tract causing pain and discomfort.
  4. Urethral stricture is a condition when the urethra narrows and this causes burning and pain during urination in women.
  5. Urethritis is the inflammation of the urethra in women can cause burning on urination.
  6. Pelvic inflammatory disease is an infection of the reproductive organs in women and causes abdominal pain especially during urination or sex.
  7. Bladder cancer
  8. Vulvovaginitis is a common infection of the vulva and vagina, both, and it causes burning and itching while urinating and increased vaginal discharge.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4483 people found this helpful

What Is Urethral Stricture?

MBBS, MS - General Surgery, DNB - Urology
Urologist, Delhi
What Is Urethral Stricture?

The urethra is a thin tube that is responsible for carrying urine from the bladder. The urethra is wide enough to facilitate a free flow of urine. However, in some cases, the tube can narrow down and it can restrict urinary flow. This condition is known as a urethral stricture. It is a condition that affects mostly men.

Causes:
The inflammation of the tubular tissues or the presence of scar tissue is the number one cause for urethral stricture. In some cases, an accident or the injury to the groin area can also lead to the formation of such thin tubes. The other factors can include pelvic fractures, radiation, urinary infection and in some cases even STDs(Sexually Transmitted Disease).

Symptoms:
Most of the symptoms of Urethral stricture are mild. Only in some rare cases, the symptoms can be extreme. These can include weak or restricted urine flow, frequent urges to urinate, and feeling of heaviness in the bladder, a burning sensation during urination, swelling and pain while urinating. Sometimes your urine may discharge volts of blood and the color of urine may change.

Diagnosis:
Diagnosis is by a physical examination and by analyzing the urine samples. In most of the cases, the thickness of the walls is measured by cystoscopy. The rate of the urine passed may also be checked for identifying the symptoms.


Treatment:
Treatment depends on the severity of the condition. Nonsurgical methods aim to improve the width of the urethra. This is done by using an instrument called a dilator. This is done as an outpatient procedure. This procedure is the most common method done and is done for most of the milder cases. Surgery is another option. The surgery aims to remove the heaviness of the urethra and enlarges the size of the flow.

Urine Flow Diversion:
This is done in extremely rare cases if the bladder has to be completely removed. In those cases, hole in the abdomen is done and urine is bypassed to that hole. However, this is an extremely rare scenario.

Prevention:
Try to avoid injuries in the groin area. If you are playing sports or a fitness enthusiast, use proper protection for your abdominal and groin regions. Try to always have safe sex and if you feel that there is some discomfort or some uneasiness while passing urine, do consult with a doctor immediately. In many cases, the condition can be avoided if proper precautions are taken.

In case you have a concern or query you can always consult an expert & get answers to your questions!

1867 people found this helpful

Stricture Urethra - Signs You Are Suffering From It!

MBBS MS DNB MNAMS NYAMS
Urologist, Mohali
Stricture Urethra - Signs You Are Suffering From It!

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:

  1. Inability to urinate
  2. Reduction in the flow of urine
  3. Increased urge to urinate frequently
  4. Pain while urinating
  5. Urinary incontinence
  6. Abdominal pain
  7. Swelling of the penis
  8. Discharge from the urethra
  9. Blood in the urine or semen
  10. Dark urine
  11. 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. If you wish to discuss about any specific problem, you can consult a Urologist.
3605 people found this helpful

Urinary Tract Obstruction - 7 Causes Behind It!

MBBS, DNB ( General Surgery ), DNB - Urology/Genito - Urinary Surgery
Urologist, Pune
Urinary Tract Obstruction - 7 Causes Behind It!

Lower Urinary tract obstruction refers to a condition of hindrance to urinary flow from bladder outwards. This can occur in all the age groups and affect either sex. The symptoms can be poor urine flow, intermittent flow, straining to pass urine or empty bladder, sense of incomplete emptying of bladder, difficulty in starting urination. Other problems can be increased urine frequency and difficulty to hold on with or without occasional urine leak in clothes. The cause and treatment vary in different age groups.

Few common reasons behind Lower urinary Tract Obstruction:

  1. Congenital Urethral Stricture and PUV: These defects can be detected either before or after birth and need correction at earliest to avoid long-term complications. It is usually brought to attention by parents who observe abnormal urine flow pattern of their child OR found out during evaluation for repeated urinary tract infections.

  2. Neurogenic Bladder: This is caused due to defects of nerves that are responsible for controlling bladder function. This can be due to diseases of brain, spinal cord or peripheral nerves. These defects can occur by birth or later in life. It is very important to take early consult to avoid long-term complications and progression to renal failure.

  3. Urethral Stricture: This is narrowing in a long tube that starts from bladder to the external urinary opening. It can be idiopathic, post-traumatic, or due to urethral infections. Usually, a person is able to recognise poor urine flow and bring it to the attention of urologist.? Treatment for stricture depends on various factors and range from simple endoscopic surgery to open surgeries.

  4. Bladder Neck Obstruction: Bladder neck is a network or a group of muscles that connect the bladder to the urethra. The muscles tighten to hold urine in the bladder, and relax as they release it through the urethra. Urinary tract obstruction occurs when there are abnormalities blocking the bladder neck that restricts its opening during urination.

  5. BPH: This occurs due to enlarged prostate obstruction urine flow out of bladder. Prostate enlargement is mostly age-related and rarely due to prostatic tumors. Urinary stones. This can be usually recognized by sudden obstruction to urine flow in person who was voiding normally. These episodes might be recurrent due to movement of stone in between bladder and urethra.

  6. Bladder Tumors: The are mostly characterized by blood in urine. Sometimes there might be blood clots that obstruct the urine flow. Phimosis: Usually occurring post-puberty, it is referred to as the inability to retract the glans (the sensitive structure at the end of the penis). It is a condition in which the distal foreskin, which was previously retractable, is unable to retract anymore.

  7. Phimosis: Phimosis is another major reason behind urinary tract obstructions.

2086 people found this helpful

Stricture Urethra - Symptoms And Treatment!

MBBS, MS - General Surgery, DNB - Urology/Genito - Urinary Surgery, MNAMS (Membership of the National Academy) (General Surgery)
Urologist, Ghaziabad
Stricture Urethra - Symptoms And Treatment!

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:

  1. Inability to urinate
  2. Reduction in the flow of urine
  3. Increased urge to urinate frequently
  4. Pain while urinating
  5. Urinary incontinence
  6. Abdominal pain
  7. Swelling of the penis
  8. Discharge from the urethra
  9. Blood in the urine or semen
  10. Dark urine
  11. 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.
2790 people found this helpful

Popular Questions & Answers

Hi, After Endoscopic surgery for Stricture Urethra. .should we take complete bed rest .or we can go out and do our works freely. Please kindly tell me.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear Shafi , hi Warm welcome to Lybrate.com I have evaluated your query thoroughly . * You are with indwelling catheter after stricture surgery for certain weeks period , depending upon the severity of the stricture . * Many people can work fine with catheter in clothes without hesitation , some patients do not like to go at work with catheter , they wait till the catheter is removed . * On medical grounds , you can do work with catheter if it fits to your personality and body habits . Hope this clears your query . Wishing you fine recovery . Welcome for any further assistance . Regards take care .
1 person found this helpful

I got stricture urethra. Doctor suggested to go for endoscopic surgery. After endoscopic how many days we should take bed rest. Please tell me.

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear Shafi , hi Warm welcome to Lybrate.com I have evaluated your query thoroughly . * After endoscopic surgery till the period you have catheter , bed rest is recommended . Hope this clears your query . Wishing you fine recovery . Welcome for any further assistance . Regards take care .
2 people found this helpful

Hello sir, I had done optical urethrotomy surgery last 25 days ago. Now I want to smoke and take alcohol. Can I smoke and take alcohol. What are the effects if I smoke.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
Dear user. I can understand. Tobacco is addictive. Cigarette also contains 4000+ carcinogenic chemicals other than nicotine. Smoking can affect your mouth, throat, lungs, heart, stomach and brain in many ways. Cancer is one among the potential diseases smoking can cause. The best method is to leave it and continue with your will power. There are other methods like Nicotine Replacement therapy and pharmacotherapy combined. Nicotine chewing gums too help as an alternative for cigarettes. But still you will need will power. You may consult a physician or deaddiction therapist or a rehabilitation facility for further advice. You can also opt for online deaddiction therapy. Take care.

Can urethral stricture occurs after cystoscopy in 2 to 3 months? As I start feeling pain in urethra and slow stream even after taking alpha blocker as I have prostatitis Thanks.

MS
General Surgeon, Panipat
Mr. lybrate-user. Stricture can develop in urethra after instrumentation but infection chances are also there so get your urine complete examination done if pus cells present get the urine culture done and then see your treating doctor.
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
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