Related articles: Urethral stricture
Definition
Urethral stricture consists in reducing the caliber of the urethra, which results in difficulty in emptying the bladder. The disorder predominantly affects male individuals.
Urethral stricture can be congenital or acquired. The forms present from birth are found due to malformations mainly affecting the navicular fossa or membranous urethra.
The acquired urethral strictures are, instead, the result of traumas and inflammatory processes that damage the urethral epithelium or the cancellous body and determine the formation of scar tissue. Pelvic fractures and iatrogenic lesions caused, for example, by prolonged catheterization, medical procedures or surgical interventions (eg cystoscopy, TURP or radical prostatectomy) promote the onset of the disorder. Less frequent causes may include lichen sclerosus and urethritis (usually chronic and untreated). Urethral stricture can also result from recurrent urinary tract infections and sexually transmitted diseases.
Most common symptoms and signs *
- Anuria
- Dysuria
- Pain in the penis
- Groin pain
- Pelvic pain
- Urethral leaks, sometimes visible only after squeezing the glans
- pollakiuria
- Rectal prolapse
- Urethral itching
- Urinary retention
- Blood in the ejaculate
- Blood in the urine
- Strangury
- Bladder tenesmus
- Urethrorrhagia
Further indications
Urethral stenosis often involves obstructive symptoms, such as: difficulty in starting urination, deviation of urinary flow, reduction in the range and strength of the mite, urinary intermittence and a feeling of incomplete emptying of the bladder. In addition, urine drips at the end of urination and pollakiuria are found.
Some people also experience urine leakage, hydronephrosis and acute or chronic urinary retention.
In addition, complications can arise, such as recurrent attacks of cystitis and prostatitis, which manifest themselves with secretions from the urethra, burning with urination, groin and suprapubic pain, periurethral abscesses, fistulas, diverticula and urinary tract stones.
Urethral stenosis is generally suspected when difficulty is encountered in urethral catheterization. The diagnosis is confirmed with uretrocystography or cystoscopy.
The treatment of urethral strictures must be appropriate to the type of stenosis and the patient's condition. One approach is to dilate the stenosis with the help of catheters or probes of increasingly large caliber. Other therapeutic possibilities include endoscopic urethrotomy (incision of stenosis by scalpel or laser) and urethroplasty (removal and replacement of the stenotic tract).
