Urethral Stricture refers to any narrowing of the urethra for any reason whether or not it actually impacts the flow of urine out of the bladder. Any inflammation of urethra can result in scarring, which then can lead to a stricture or a narrowing of the urethra. Trauma, infection, tumors, surgeries, or any other cause of scarring may lead to urethral narrowing or stricture. Urethral stricture is significantly more common in men and boys compared to women and girls
Types of stricture urethra surgery
- Laser endoscopic urethroplasty (OIU) here first endoscoipc examination of urethra is done to see extent and severity of stricture. in short stricture at one point 12 o clock stricture is sharply cut with laser energy to widen the urethral lumen. A Foley catheter is left for 5 days for healing. technique is good for short less dense stricture. many a time patient is adviced for self calibration of urethra to prevent recurrence.
- End to end urethroplasty here urethra is exposed from perinium (below scrotum). the strictured segment of urethra is excised. and continuituy is mantained by anastomosing normal end of urethra over a catheter. catheter is usually kept for 14 days. technique is good for short severly dense stricture. success rate is very good.
- Buccal mucosa augmentation urethroplasty here also urethra is exposed from perinium (below scrotum). but the strictured segment of urethra is not excised rather lumen is increased by adding a graft harvested from inned mucosa of one side of cheek.. over a catheter. catheter is usually kept for 14 days. The technique is good for long and dense stricture. success rate is very good.
- Trauma from injury or accidents (for example, falling on a frame of a bicycle between the legs, or a car accident)
- Pelvic injury or trauma
- Previous procedures involving the urethra (urinary catheters, surgeries, cystoscopy)
- Previous prostate surgery (TURP or transurethral resection of the prostate)
- Prostate enlargement
- Cancer of the urethra (rare)
- Infections of the urethra (sexually transmitted diseases or STDs, urethritis, gonorrhea, chlamydia)
- Prostate infection or inflammation (prostatitis)
- Previous hypospadias surgery (a congenital birth defect in which the opening of the urethra is on the underside of the penis instead of the tip)
- Congenital malformations of the urethra, which rarely can cause urethral stricture in children
- Cystoscopy: Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope. The cystoscope is inserted into your urethra and slowly advanced into the bladder.
- Urethrography: A retrograde urethrogram is a routine radiologic procedure used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture.
- Uroflowmetry: Uroflowmetry is a diagnostic test that is administered to check for abnormalities in the amount or flow rate of a patients urine. The procedure is straightforward and painless, and simply involves urinating into a funnel device attached to an electronic meter.