Urethral Stricture is a painful condition which characterizes scarring of the ureter restricting the normal flow of the urine out of the body. Ureter is the narrow tube that usually carries urine from the urinary bladder through the penis and out the urethral meatus (the opening at the tip of the penis) during urination. In case of urethral stricture, the narrowing of the tube withholds the normal flow eventually intensifying discomfort and slowing the urinary stream ultimately leading to a number of medical conditions.
Also Read: Ureteral Cancer: Causes, Symptoms And Treatment
Causes
Urethral stricture chiefly occurs due to chronic inflammation or injury making the ureter extremely narrow and restricting normal flow of urine. In some cases, the stricture may happen just after the injury or long after an injury. The scarring of the internal tissue can happen due to:
- An infection of the urinary bladder, due to STD’s like Chlamydia
- An injury to the penis or the scrotum or the perineum layer.
- Insertion of catheter tubes or instruments like endoscope into the penis during certain surgical procedures
- Intermittent or long-term use of catheters for draining urine
- An enlargement of the prostate gland or a past surgery to remove or reduce an enlarged prostate gland
- Prostrate cancer or urethral cancer
- Radiation therapy
- Pelvic fracture
- Benign prostatic hyperplasia
- A tumour located near the urethra
- Repetitive or untreated urinary tract infection
Risk Factors
Certain causative factors that influence the stricture in the urethra includes:
Infection: A person suffering from one or more STI's is more at risk of developing urethral stricture.
Also Read: Chlamydia: Causes, Symptoms And Treatment
Surgical Procedure: A recent insertion of catheter tube can aggravate the chances of getting this condition.
Health Condition: A person diagnosed with urethritis (swelling and irritation in the urethra), is more prone to developing urethral stricture.
Symptoms
The common signs and symptoms of urethral stricture may range from mild to severe and includes:
- Reduction of the volume of urine or flow of urine
- Pain or burning sensation during urination
- Urinary incontinence
- Urinary tract infection
- Pelvic pain or pain in the lower abdominal area
- Urethral discharge
- Swelling of the penis
- Frequent urge to urinate
- Feeling of incomplete emptying of bladder after urination
- Presence of blood in the semen or urine
- Prostatitis
- Hydronephrosis and renal failure
- Difficulty or inability to urinate
Diagnosis And Treatment
If you notice any of the above-mentioned signs or symptoms, do consult a doctor right away to get it diagnosed and start the treatment at the earliest. The doctor usually does a thorough physical check-up of the penis area to look for presence of stricture, acknowledges the patient’s past medical history and conducts a few diagnostics. These include:
- Measuring the rate of flow or urine during urination
- Measuring the size of the urethral opening
- Urinalysis to determine the presence of sexually transmitted infections like chlamydia or gonorrhoea
- Urine culture to analyze the physical and chemical properties of urine to determine if bacteria (or blood) is present in it
- Cytoscopy to view the inside of the bladder and urethra
- Ultrasound technique to assess the presence of urine left in the bladder
- Antegrade cystourethrogram
- Cystourethroscopy
- MRI and CT scan
Treatment
In most cases, once a scar forms inside the ureter, it doesn’t go away on its own. It usually depends upon the severity of the condition and the doctor usually conducts procedures to increase the internal diameter of the ureter and reduce discomfort. This involves:
- Urethral dilation
- Urethral stent placement
- Direct vision internal urethrotomy (DVIU)
- Open urethral reconstruction
- Urine flow diversion