WHAT ARE URETHRAL STRICTURES?
Urethral strictures are a buildup of plaque (usually from scar tissue) that closes or restricts the urethral passage within the body.
SYMPTOMS OF URETHRAL STRICTURES
Simply put, the urethra is like a garden hose. When there is a kink or narrowing along the hose, no matter how short or long, the flow is reduced. When a stricture is narrow enough to decrease urine flow, you will have symptoms. Problems with urinating, UTIs, and swelling or infections of the prostate may occur. Severe blockage that lasts a long time can damage the kidneys.
Some symptoms of urethral strictures are:
- Bloody or dark urine
- Blood in semen
- Slow or decreased urine stream
- Urine stream spraying
- Pain with urinating
- Abdominal pain
- Urethral leaking
- UTIs in men
- Swelling of the penis
- Loss of bladder control
WHAT CAUSES URETHRAL STRICTURES?
The most common cause of urethral strictures appears to be chronic inflammation or the development of scar tissue. Scar tissue can gradually form from:
- An injury to the penis or scrotum, or a straddle injury.
- An infection, most often sexually transmitted diseases like chlamydia.
- Placement of catheters or instruments used by urologists during surgery or procedures to examine the urethra and bladder (especially if the catheters are left in for longer than they are prescribed to be in)
The scar tissue causes the urethra to become gradually narrow, making it more difficult for urine to flow. Sometimes, the inflammation/injury to the urethra happens long before the stricture becomes noticeable. In other cases, the stricture happens soon after a urethral injury.
PREVENTING URETHRAL STRICTURES
The following are ways to prevent developing urethral strictures:
- Avoid injury to the urethra and pelvis
- Be careful with self-catheterization
- Use lubricating jelly liberally
- Use the smallest possible catheter needed for the shortest time
- Avoid sexually transmitted infections.
- Use condoms and/or avoid sex with partners who have gonorrhea or chlamydia (chlamydia is now the more common STI cause of urethral strictures)
TREATMENT FOR URETHRAL STRICTURE?
Treatment for urethral strictures depends on the severity of the condition.
NONSURGICAL TREATMENT FOR URETHRAL STRICTURES
The primary mode of treatment is to make the urethra wider using a medical instrument called a dilator. This is an outpatient procedure, meaning you won’t have to spend the night at the hospital. A doctor will begin by passing a small wire through the urethra and into the bladder to begin to dilate it. Over time, larger dilators will gradually increase the width of the urethra.
Another nonsurgical option is permanent urinary catheter placement. This procedure is usually done only in severe cases as it comes with risks such as bladder irritation and urinary tract infection.
SURGICAL TREATMENT FOR URETHRAL STRICTURES
Surgical treatment for urethral strictures is another option. An open urethroplasty is an option for longer, more severe strictures. This procedure involves removing affected tissue and reconstructing the urethra. Results vary based on stricture size.
URINE FLOW DIVERSION
In severe cases, a complete urinary diversion procedure may be necessary. This surgery permanently reroutes the flow of urine to an opening in the abdomen. It involves using part of the intestines to help connect the ureters to the opening. Urinary diversion is usually only performed if the bladder is severely damaged or if it needs to be removed.