Urethral stricture is the term applied to abnormal narrowing of the anterior urethra, whereas the american urologic association prefers the term stenosis for narrowing of the posterior urethra, which lacks spongiosum. In children, urethral strictures most often follow reconstructive surgery for congenital abnormalities of the penis and urethra, cystoscopy and occasionally may be congenital. In adults, urethral strictures from instrumentation trauma may occur after prostate surgery and urinary catheterization. Imaging of the anterior male urethra has traditionally been performed by fluoroscopic contrast urethrography. It is a medical condition which mainly affects men. The management of urethral stricture in women includes urethral dilatation, urethrotomy, clean isc and substitution urethroplasty 10,15. The urethral mucosa is enveloped by corpus spongiosum. Urethral stricture is the preferred term for any abnormal narrowing of the anterior urethra, which runs from the bulbar urethra to the meatus and is surrounded by the corpus spongiosum. This bloodrich erectile tissue surrounds the urethra from the meatus to the bulbar urethra. Any information contained in this pdf file is automatically generated from digital. Retained selfinserted foreign body into the urethra. Food and drug administration fda approves clinical trial of drugcoated balloon catheter truckee, ca doctors are beginning a clinical study of a new medical solution that could dramatically change the way urethral strictures are treated today for millions. The female urethra begins at the internal urethral meatus at the bladder. Mundy institute of urology and nephrology, london, uk introduction in most instances a urethral stricture is a narrowing of the calibre of the urethra caused by the presence of a scar consequent on infection or injury.
Such an operation was however not without its difficulties, for fistulae were common, and unless great care were. Repair pdf file upload a corrupt pdf and we will try to fix it. This thin tube also has an important role in ejaculation for men. Rg hospital offer best urethral stricture treatment and surgery by top experienced doctors. Definition urethral stricture is a narrowing of the urethra caused by scarring, which functionally has the effect of obstructing the lower urinary tract. Stricture is that condition where there is an abnormal diminution of the caliber of the canal, induced by pathologic changes in the mucous or submucous muscular walls of the urethra. Describe the anatomy of the urethra as well as the technique and pitfalls of urethrography. Anurethra is a tube which transforms from the bladder and it helps urine to be expelled from the body. Erectile dysfunction in urethral stricture and pelvic. A urethral stricture is a narrowing of the urethra, which can restrict urine flow from the bladder. The reason for the presence of a proximal urethral stricture in some patients may be trauma from repeated dilatations or instrumentation 12. The scrotum is the skin sac that contains the testicles, its attached blood vessels and ducts which transport sperm from the testis through the vas deferens. Management of posterior urethral stenosis from the treatment of prostate cancer.
Links to pubmed are also available for selected references. Urotronic offers new hope for men suffering from urethral. Urethral stricture is significantly more common in men and boys compared to women and girls. Urethral strictures and their surgical treatment d. A pain in the scrotum and urethral strictures canadian urological. Incidence, causes, and complications of urethral stricture. This scar is due to fibrosis to the lumen of urethra and to a more severe level the fibrosis will occur at corpus spongiosum. Urotronic offers new hope for men suffering from urethral strictures u. Urethral dilation is a commonly attempted technique for treating urethral strictures.
Some of the signs of a urethral stricture include weak urine flow or reduction in thevolumeofurine,urinaryurgency,painduringurination, incontinence, pain in the pelvic or lower abdominal area, urethral discharge, penile swelling, the presence of blood in. Whenit had healed, a skin strip was used to formanewurethra fig. Frequently asked questions about urethral stricture. This stricture makes it difficult to urinate by reducing or blocking the flow of urine out of the bladder. The urethra is divided into 2 areas, the inner urethra and the outer urethra. Urethral trauma associated with urethral catheterization is a potential cause of urethral rupture, uroabdomen and urethral strictures in cats. A stricture in the urethra can cause weakening or spraying urine stream, painful urination and occasionally blood from the urethra.
This procedure is done under local or general anesthesia. Urethral stricture treatment ahmedabad best urethral. Diagnosis and treatment usually do not create clinical. Urethral strictures are associated with varying degrees of spongiofibrosis. The hallmark sign of urethral stricture is a weak urinary stream. It usually involves scar tissue formation, which typically occurs due to an infection, other. Management of posterior urethral stenosis from the. Depending on how much the pdf is damaged we will be able to recover it partially or completely. Posterior urethral valves oxford university hospitals.
Overview covers causes, incidence, risk factors, symptoms, treatment, complications and prevention. Management of urethral stricture in women request pdf. Urethral stricture guideline american urological association. The inner urethra is the part closest the bladder and at its innermost level is envelope by the prostate gland. Imagine a narrowing or kink in a garden hose which will slow the stream of water. Get a printable copy pdf file of the complete article 6. The glans penis differs markedly from the penile and bulbar urethra in. Urethral strictures can cause numerous signs and symptoms that range from mild to severe. Uti urinary tract infection urology network clean intermittent urethral catheterisation in adults ii. Atthefirst stage the narrowinflamed part of the urethra was laid open or cut away entirely. A urethral stricture is a scar that causes narrowing at one or more points in the urethra or at the point where the urethra connects to the bladder a bladder neck contracture. Many individuals with a stricture will have a diminished rate of flow. It is an accurate tool for the diagnosis and characterization of strictures, particularly of the bulbar urethra.
It affects the urethra the tube which carries urine from the bladder to the. The plate may be too short in hypospadias, or scarred after previous repair or due to a dense urethral stricture. A urethral stricture is a narrowing of the urethra, the tube through which urine leaves the bladder and exits the body. The epithelium itself is usually intact, albeit abnormal 8,27 fig. Urethral stricture scarring of corpus spongiosum and overlying urothelium. Procedures in family practice dilation of the urethra in males john h. Strictures may be divided into inflammatory, true or organic stricture and false or spasmodic stricture, and divided. Urethral strictures that are present at birth congenital are rare. Longterm sequelae of selfinserted foreign bodies into the urethra are represented by urethral stricture, urethral diverticulum and erectile dysfunction 3, 9, but it is not easy to relate them to their predisposing cause in practice because patients do not report their habits during the consultation. Posterior urethral valves puv is a problem that occurs in some baby boys from birth. Procedures in family practice dilation of the urethra in males. Urethroplasty is a surgery where the urethra is reconstructed to cure problems like urethral strictures. Urethral stricture occur predominantly in males for the male urethra is 67 times longer than the female urethra see figure 1, allowing both infection and surgical damage to occur more frequently. Urethral stricture is defined as a narrowing of the urethra.
Most surgeries take between three to six hours to complete. Inlayonlay flap urethroplasty for hypospadias and urethral stricture repair. In men, the urethra is a tube that carries urine from the bladder, and semen from the ejaculatory ducts, out of the body. Some people are born with a urethral stricture, but they can occur at any age.
The urethra s main job in males and females is to pass urine outside the body. This elastic tube remains patent and is under the control at the neck of the bladder. The files of all the men who were diagnosed with urethral stricture from may 2006 to april 2016 were retrieved from. Normally, urethra is wide enough to give a free flow, but when it becomes narrow it may create a restriction for urinary flow, it calls urethral stricture. Rarely, it may be caused by pressure from a growing tumor near the urethra. From the bladder, it goes through your prostate, your external sphincter muscle that helps you remain continent, your perineum the area between scrotum and anus and your penis. The types of surgeries are varied and depend upon the location, cause, and length of the stricture. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Urethral stricture is a scarring process of the urethral mucosa and surrounding spongy tissues of the corpus spongiosum latini et al. Clean intermittent urethral catheterisation in adults. The male urethra is a tubular structure that begins at the neck of the urinary bladder and ends at the tip of the penis, serving to conduct urine from the bladder through the penis.
Intermittent selfobturation for urethral stricture or. Full text full text is available as a scanned copy of the original print version. Overall 32% success rate for anterior urethral strictures at 98 months pansadoro 1996 maintaining urethral patency 37 days urethral catheterisation equivalent to 6 weeks urethral patency can be maintained by urethral dilatation, but this. This narrowing causes difficulty with passing urine, including straining and pain in the urethra. Excepting trauma or otherwise when the urethral lumen is obliterated, the characteristic feature of a stricture is replacement of the corpus spongiosum deep to the urethral epithelium by dense. Urethral stricture may be caused by swelling or scar tissue from surgery. The absence of a segment of the urethral plate renders the onlay urethroplasty procedure impossible. Rearrange individual pages or entire files in the desired order. Thin rods of increasing diameters are gently inserted into the urethra from the tip of the penis meatus in order to open up the urethral narrowing without causing any further injury to the urethra. Pdf urethral stricture disease in men researchgate. This guideline provides evidence guidance to clinicians and patients regarding how to recognize symptoms and signs of a urethral stricture stenosis, carry out appropriate testing to determine the location and severity of the stricture. Urology a urethral stricture is a narrowing of the urethra caused by injury, instrumentation, infection, and certain noninfectious forms of urethritis.
Koontz, jr, md richmond, virginia treatment of male urethral strictures can be safely performed. This guideline provides evidence guidance to clinicians and patients regarding how to recognize symptoms and signs of a urethral stricture stenosis, carry out appropriate testing to determine the location and severity of the stricture, and recommend. My object in this paper is to call attention to the fact that congenital strictures of the meatus of the female urethra, long disregarded by the medical profession, actually exist and are really of great importance. Urethra is a fine tube through which urine flows out from the bladder and passes through the external genitalia in men and above the vagina in women. A urethral stricture is a narrowing or restriction of the urethra the tube from your bladder through which you pass urine and has been a familiar problem to medical science for thousands of years. Urethral stricture disease tom walton january 2011 2 poor results for nonbulbar and multiple strictures.
554 1387 955 356 742 1223 229 597 613 141 324 555 396 363 1458 583 1341 484 96 372 346 1165 1432 1111 983 1190 126 868 1350 1405 958 941 632 1199 1201 1072 599 842 1114 751 72 439 469 990 432 1184 1319 1312 726