Urethroplasty – Urethral strictures

Urethra is the bladder through which urine passes to the outside world form bladder where urine stored. The narrowing of urethral tract is known as urethral strictures. Urethral strictures may restrict the flow of urine through urethra slightly or severely. Small strictures may be less than one cm in length and big strictures which may cover the entire urethra are possible in the urethra.

Causes of urethral strictures

Urethral strictures are usually caused by the presence of scar tissues or inflammation in the urethra. Damage to urethra may be caused due some procedures that is carried out to look into the bladder via urethra. Damages caused by radiotherapy and by accidental falls etc may also cause damages to the urethra. Infection of urethra can be caused by sexually transmitted diseases like gonorrhoea, chlamydia, or can be as a result of long term use of catheter, and infection can cause inflammation in an around the tissues of the urethra. Inflammation usually clears by medications, but it leaves some scar tissues which may lead to strictures. Some babies are found to have congenital urethral strictures. Cancer of urethra also very rarely can be the cause for urethral strictures.

Diagnosis

Doctor will study the medical history and symptoms shown by the patient. One or more of the following tests may be recommended for determining the exact location and the length of the stricture. He will also conduct a physical examination of the patient.

Urinalysis: This test is conducted to find traces of infection, blood or cancer in the urine.

Ultra sound scan: Ultra sound scan is conducted to understand the length of the stricture.

Pelvic ultra sound: This test is conducted to find the presence of urine in the bladder after urination.

Cystoscopy: This is a procedure in which the bladder and the urethra are examined using a tube- like device fitted with a lens with the help of which the above organs are viewed.

Retrograde urethrogram: In this test X-ray images are used to check the injuries or structural problems, if any, of the urethra.

Treatment for urethral strictures

Catheterization: This is a procedure in which a catheter is inserted to the bladder through urethra for the removal of urine from the bladder. This is the first step in the case of complete urine blockage. Some patients are able to perform self catheterization which is simply inserting the catheter through the urethra to the bladder and removing the urine in it.

Urethroplasty: Urethroplasty is the surgical name of the procedure followed by some surgeons to enlarge the narrowed sections of the urethra. The advantage of this procedure is that the rate of recurrence of strictures is very less in this procedure.

Cystocopy: Cystoscopy is a procedure in which an endoscope is inserted through urethra and with the help of other special instruments inserted through the cystoscope the strictures are removed either vaporization or with the help of lasers.

Dilation: in this procedure the surgeon inserts a tiny wire to the urethra which is then passed to the bladder. Larger dilators are inserted progressively which will help in increasing the width of the passage. This is usually carried out as an outpatient service for patients with recurring strictures.