A penile urethral stricture is a narrowing of the urethra, the tube that carries urine from the bladder out of the body. This narrowing can cause difficulty urinating, pain, and other problems.
Several factors can cause a penile urethral stricture, including scar tissue from injury or infection, inflammation, and certain medical procedures. Treatment options depend on the severity of the stricture and may involve minimally invasive procedures, surgery, or medications.
A study published in the Journal of Urology by C. Chen et al. in 2018 found that the most common causes of urethral stricture are related to inflammation and infections.
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What Are the Causes of Urethral Stricture?
The most common causes of urethral stricture are scar tissue formation, which can be the result of a number of different factors. The scar tissue can form due to infections, injury, prostate surgeries, or even genetic conditions.
Other known causes of urethral stricture include…
- Polymyalgia rheumatica (PMR)
- Radiation therapy for cancer
- Lichen sclerosus
- Pelvic floor dysfunction
Urethral stricture can also be a result of unknown causes.
Symptoms of urethral stricture include weak urine stream, bladder that doesn’t empty completely, spraying or dribbling urine, pain during urination, and difficulty urinating.
If you suspect you have urethral stricture, it’s essential to see a healthcare professional. They can perform tests, such as a urine test, ultrasound, or urethral catheterization, to diagnose the condition and determine the best course of treatment.
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Management of complex urethral strictures
The management of complex urethral strictures, specifically within the male urethral stricture disease domain, primarily involves urethral reconstruction. Treatment options vary based on the length of the stricture, its location—be it bulbar urethra, posterior urethra, or complex anterior urethral strictures—and the history of any urethral trauma. Urethral reconstruction aims to restore the urethral lumen’s patency, often employing the urethral plate when viable.
In instances where the urethral plate is not usable, grafts or flaps may be required to repair the strictured segment. For recurrent urethral strictures, a thorough assessment identifies the cause, guiding the choice between repeated urethral dilation, urethroplasty, or the insertion of a urethral catheter as interim management.
Stricture recurrence demands meticulous evaluation to decide on either endoscopic treatment or open surgical repair, factoring in the previous interventions’ outcomes. The selection of treatment for urethral stricture hinges on the stricture’s characteristics and the presence of any complicating factors, such as stricture length and associated urethral meatus involvement. Therefore, the management of urethral stricture, particularly complex strictures, requires a tailored approach designed to minimize stricture recurrence and preserve urinary function.
What is the success rate of penile urethral strictures?
The study “Urethroplasties for male urethral strictures: Success rates and predictive factors,” published in Prog Urol in 2022, analyzed the success rates and predictive factors of urethroplasty treatment for male urethral strictures at a single center. The overall success rate was 69% (CI95% [60-79]) for a mean follow-up of 62.85 months. The study also identified suprapubic urinary drainage as a predictive factor that improved surgery outcomes.
Can urethral stricture be treated without surgery?
Yes, urethral strictures can be treated non-surgically in certain cases. For mild strictures with minimal scar tissue, doctors may recommend active surveillance, urethral dilation, or an endoscopic incision in the urethra instead of surgical procedures. However, without treatment, urinary and testicular infections can occur and may worsen over time. It’s important to consult a healthcare professional for an accurate evaluation and treatment plan.
How long does it take for an urethral stricture to heal?
The healing time depends on the severity of the stricture and the type of treatment used.
Here’s a breakdown of factors affecting healing time:
- Severity of Stricture: Generally, smaller strictures treated with dilation (widening the urethra) heal faster, within days or weeks. More severe strictures requiring urethroplasty (surgical repair) take longer to heal, with recovery often involving catheter use for several weeks and restrictions on activity for a few months.
- Treatment Method: Dilation is a minimally invasive procedure with a shorter recovery time. Urethroplasty is a surgery requiring more healing time.
Following doctor’s instructions regarding post-treatment care plays a vital role in healing and reducing the risk of recurrence. This may involve avoiding strenuous activity, using medications, and attending follow-up appointments to monitor progress.
Can I live with urethral stricture?
Yes, you can live a full and normal life with a urethral stricture. While there is no cure, effective treatments exist to manage the condition and prevent complications. Early diagnosis and treatment are key for optimal outcomes.
How do I know if I have urethral stricture?
You may have a urethral stricture if you experience changes in your urination habits, particularly difficulty passing urine.
Some specific symptoms to watch for include:
- A weak or slow urine stream
- Feeling like you can’t empty your bladder completely
- Frequent urination or a sudden urge to urinate
- Pain or burning during urination
- Blood in the urine
If you experience any of these symptoms, it’s important to see a doctor to get a diagnosis and discuss treatment options.
Strictures can significantly hinder your ability to live a normal life. If you are having any symptoms then Dr. Samarth Agarwal can help you.