Urethral stricture refers to the narrowing of the urethra, the tube that carries urine from the bladder out of the body. This condition can cause various urinary symptoms and requires medical attention for proper management. At SHIFAA PAN African Hospitals, our urology experts specialize in diagnosing and treating urethral strictures to improve patients’ urinary function and quality of life.

Understanding Urethral Stricture:

Causes and Mechanisms:

• Trauma: Injuries to the pelvic area, such as from accidents, catheterization, or surgical procedures, can lead to scarring and narrowing of the urethra.
• Infections: Sexually transmitted infections (STIs), urinary tract infections (UTIs), or inflammatory conditions can cause urethral inflammation and scarring.
• Idiopathic: In some cases, the exact cause of urethral stricture may not be clear.

Risk Factors:

• Male Gender: Urethral strictures are more common in males.
• Age: Older adults may have an increased risk due to age-related changes or medical conditions.
• Prior Medical History: History of urethral trauma, catheterization, recurrent infections, or previous urethral surgeries.

Symptoms and Diagnosis:

Common Symptoms:

• Urinary Flow Changes: Weak urine stream, difficulty initiating or maintaining urination (hesitancy), or incomplete bladder emptying.
• Urinary Urgency: Feeling the need to urinate urgently or frequently.
• Pain or Discomfort: Painful urination (dysuria), pelvic pain, or discomfort during urination.

Diagnostic Procedures:

• Medical History and Physical Examination: Including a detailed history of symptoms and urological examination.
• Imaging Studies: Retrograde urethrogram (RUG), ultrasound, or urethroscopy to visualize and assess the urethral structure and narrowing.
• Uroflowmetry: Measures urine flow rate to assess the severity of urinary flow obstruction.

Treatment and Management:

Minimally Invasive Procedures:

• Urethral Dilation: Widening the narrowed urethral segment using gradual dilation with specialized instruments.
• Urethrotomy: Surgical incision or laser therapy to open up the stricture and improve urine flow.
• Stent Placement: In some cases, temporary or permanent stents may be inserted to maintain urethral patency.

Surgical Interventions:

• Urethroplasty: Surgical reconstruction of the urethra to remove scar tissue and widen the narrowed segment, often considered for complex or recurrent strictures.
• Open Surgery: Rarely needed but may be considered for severe strictures or when other treatments are ineffective.

Post-Treatment Care and Follow-up:

Recovery and Monitoring:

• Close monitoring post-procedure to assess urinary function, flow rate, and symptom improvement.
• Follow-up appointments to monitor for stricture recurrence and address any complications or new symptoms.

 

What are the common causes of urethral stricture, and who is at risk?

Causes include trauma, infections, and idiopathic factors. Men, older adults, and individuals with a history of urethral issues or procedures are at higher risk.

 

What symptoms suggest a urethral stricture, and how is it diagnosed?

Symptoms include changes in urinary flow, urgency, and discomfort. Diagnosis involves physical exams, imaging tests, and urological evaluations such as urethroscopy.

 

What treatment options are available for urethral strictures?

Treatments range from minimally invasive procedures like dilation and urethrotomy to surgical interventions such as urethroplasty or stent placement, depending on the stricture’s severity and location.

 

Can urethral strictures recur after treatment, and how are they managed long-term?

Recurrence is possible, and long-term management involves regular follow-ups, monitoring for symptoms, and prompt intervention if recurrence occurs.

 

Are there lifestyle changes or precautions individuals with urethral strictures should consider?

Maintaining good urological health, avoiding risky behaviors that can lead to trauma or infections, and attending regular urology check-ups can help manage and prevent complications related to strictures.

 

What are the potential complications of untreated urethral strictures?

Untreated strictures can lead to worsening urinary symptoms, recurrent infections, bladder issues, and kidney problems due to urinary retention. Seeking timely medical care is essential for optimal outcomes.