The urethra helps discard the urine stored in the bladder outside the body. The urethra is a simple 4–5-cm-long organ in women, and it is a complex, 15–20-cm-long structure in men. Men have spongy tissue called a corpus spongiosum wrapping around the urethra. Any damage to this structure can lead to improper wound healing and urethra strictures.
What is a Urethra Stricture? What Causes a Urethra Stricture?
A urethra stricture is a clinical problem characterised by fibrosis (bad wound healing) due to any damage and tightening in the urinary tract. There are multiple reasons for a urethra stricture. Urologic interventions in men (operations such as TURP, TURM),a catheter, passing a kidney stone, urethritis (sexually transmitted diseases) or trauma to the perineal area might cause a urethra stricture and injury.
What are Urethra Stricture Symptoms?
The most common symptoms of a urethra stricture are decreased urine pressure or thin urination. Patients complained about urinating problems and forked urine. The more advanced strictures might appear as urination, like dripping or no urination at all.
Patients with undiagnosed or untreated urethra strictures might have urinary tract infections and bladder stones. With that, the patients might have a burning sensation when urinating or abdominal pain complaints.
How is a Urethra Stricture Diagnosed?
The most important step in the diagnosis of a urethra stricture is the medical history of the patient. The uroflow test will be an indicator of patients with suspected urethra strictures. A special X-ray called a ureterogram is necessary for the diagnosis of urethra strictures. Imaging with endoscopes and a camera, called cystoscopy, plays an important role in both the diagnosis and treatment of the disease.
What will Happen if the Urethra Stricture is Not Treated?
If the urethra stricture is left untreated, it might cause a urinary tract infection, bladder stones and kidney failure due to insufficient urine discharge. The infections caused by the urethra stricture might cause high pressure on the urinary tract, which might lead to prostate and testicle inflammation by passing to the testicles or prostate.
Will a Urethra Stricture Heal on its Own?
The urethra stricture is a machine that is a physical stricture on the urinary tract. This problem cannot be fixed on its own or with medication. The only treatment option is a surgical intervention.
Surgical Treatment Options in Urethra Strictures
It’s impossible to treat a urethra stricture with medication; the only treatment option is surgery. Patients with a complete urethra stricture might need an abdomen catheter called a cystostomy. When surgical treatment options for a urethra stricture are identified, the location of the stricture and its length are important. There are basically 2 surgical methods for urethra strictures:
- Endoscopic interventions (closed surgical options),
- Urethroplasty (open urethra surgery).
Endoscopic interventions can include an incision with a cold scalpel (urethrotomy intern),a laser urethrotomy and balloon dilatation. This is often preferred when the stricture segment is short. The success rate for endoscopic interventions is low, and the chances of relapse are high.
As the length of the stricture increases, the success rate of endoscopic interventions decreases. Some patients might need a surgical intervention once every 2–3 months, which has a significant negative impact on their quality of life. Patients with failed endoscopic interventions must not persist with endoscopic interventions; open surgery should be considered as an option.
A stem cell injection into the tissue around the endoscopic intervention area for urethra strictures can help with tissue recovery and increase the chances of success for a closed intervention. This treatment might be successful if there is no relapse.
A urethroplasty is the name for open urethra stricture surgery. You can check out our article on urethroplasty, which is important to our clinic, here.