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A urethral stricture is a narrowing of the urethra, the tube connected to the bladder that allows urination. The narrowing reduces the flow of urine and makes it more difficult or even painful to empty the bladder. [1] Urethral stricture is caused by injury, instrumentation, infection, and certain non-infectious forms of urethritis. The ...
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The protection provided by the foreskin for the glans penis and meatus has been recognized since 1915. In the absence of the foreskin the meatus is exposed to mechanical and chemical irritation from ammoniacal diaper (nappy) that produces blister formation and ulceration of the urethral opening, which eventually gives rise to meatal stenosis (a narrowing of the opening). [1]
It is also sometimes called a stricture (as in urethral stricture). [ 3 ] Stricture as a term is usually used when narrowing is caused by contraction of smooth muscle (e.g. achalasia , prinzmetal angina ); stenosis is usually used when narrowing is caused by lesion that reduces the space of lumen (e.g. atherosclerosis ). [ 4 ]
Treatment is typically with a catheter either through the urethra or lower abdomen. [1] [3] Other treatments may include medication to decrease the size of the prostate, urethral dilation, a urethral stent, or surgery. [1] Males are more often affected than females. [1] In males over the age of 40 about 6 per 1,000 are affected a year. [1]
A urethrotomy is an operation which involves incision of the urethra, especially for relief of a stricture.It is most often performed in the outpatient setting, with the patient (usually) being discharged from the hospital or surgery center within six hours from the procedure's inception.
Urethroplasty is regarded as the gold standard treatment for urethral strictures and offers better outcomes in terms of recurrence rates than dilatations and urethrotomies. It is probably the only useful modality of treatment for long and complex strictures though recurrence rates are higher for this difficult treatment group. [1]
Spot images are taken at 30 to 45 degrees to visualise the entire spongy urethra (penile urethra). [ 4 ] If there is no contraindication to full urinary catheterisation such as false passage or stricture, the urinary catheter should be inserted until the urinary bladder to perform voiding cystourethrography to visualise the prostatic urethra ...