Stenosis of the urethra is a condition in which the urethra (the tube that carries urine out of the bladder) is narrowed in some place. This constriction disrupts the natural flow of urine and can cause difficulty urinating and a number of complications.
How is this happening?
Within the urethra, scar tissue develops, narrowing its lumen.
The main reasons may be:
- Trauma (for example, as a result of catheterization or another intervention) when the instrument is inserted through the urethra or trauma occurs as a result of external impact (impact, accident).
- Sexually transmitted infections (for example, sexually transmitted diseases): the main sexually transmitted infections that can cause urethral stricture are gonorrhea and chlamydia.
- Inflammatory diseases: prostatitis, urethritis – inflammation of the urethra.
- Complications during childbirth (for women).
- Malignant tumors or complications of radiation therapy.
Possible symptoms:
- Ослабление троку мочи
- Difficult urination, pain during urination
- Feeling of incomplete emptying of the bladder
- Frequent infections of the bladder
- Prolonged urination
Diagnosis:
Stricture of the urethra is diagnosed by several methods, depending on the symptoms of the patient, the history of the disease and the doctor’s decisions. Here are the most important steps and research.
1) Patient consultation and clinical examination
- Presence of complaints (for example, weak urine stream, difficult urination).
- Previous operations, catheterizations, infections or traumas.
2. Uroflowmetry
- Special equipment measures the strength and speed of the urine stream. If the flow is slow or
weak, this may indicate a narrowing of the urethra.
3. Laboratory examination of urine and sexually transmitted infections
- To exclude inflammation or the presence of sexually transmitted infections.
4. Uretrography
- This is a radiological study with contrast material. The doctor injects a contrast agent through the outer opening of the urethra and makes an x-ray to see where the urethra is narrowed and how long it is.
5) Urethrocystoscopy
A small device equipped with a camera, a cystoscope, is inserted into the urethra. Provides direct visibility of the inner part of the urethra and bladder. This is the most direct way to see the narrowing.
Treatment options
Treatment of urethral stricture depends on the length of the stricture, its location, the patient’s general health condition, and the likelihood of recurrence. There are several options for treatment: from non-surgical to full-scale surgical intervention.
1. Дилатация (расширение)
- The narrowed part of the urethra is expanded with the help of special mechanical tools (dilator
or catheter). - In most cases, this has only a temporary effect.
- It may be necessary to re-extend.
It is used for the primary treatment method of stenosis or in cases of mild stenosis.
2. Urethrotomy (uretroscopic incision)
- This is an endoscopic method. A camera is inserted into the urethra, and the narrowed section is cut with a laser or a cold knife.
- Also called DVIU (direct visual internal urethrotomy).
- Recovery occurs quickly, but the probability of relapse is high, especially in the case of long
strictures.
3. Urethroplasty
- This is a complicated but effective operation.
- The narrowed section is removed or replaced by a flap of skin or mucous membrane (often
from the oral cavity – mucous membrane of the cheeks). - Gives long-lasting and stable results, especially in cases of recurrent or long (>1 cm) strictures.
This is considered the "gold standard" for the treatment of severe or recurrent strictures.