urethral stricture
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Introduction
structure of the urethra
Etiology
- sexually-transmitted disease
- urethral catheterization
- benign prostatitic hypertrophy (BPH)
- pelic trauma
- recurrent urethritis
Epidemiology
- congenital urethral strictures are rare
- urethral strictures in women are rare
Clinical manifestations
- blood in the semen
- bloody or dark urine
- oliguria
- urinary hesitancy or inability to urinate
- urethral discharge
- urinary frequencyInability to urinate
- urinary incontinence
- dysuria
- pelvic pain, abdominal pain
- slow urine stream
- edema of the penis
- distended bladder
- inguinal lymphadenopathy
- enlarged prostate
- physical exam may be normal
Laboratory
- urinalysis with urine culture if indicated
- Genprobe for chlamydia & gonorrhea
Diagnostic procedures
- cystoscopy
- post-void residual volume (PVR)
- retrograde urethrogram
- urinary flow rate
Complications
Management
- suprapubic catheter may necessary to alleviate urinary retention if a catheter cannot be passed through the urethra
- urethra may be widened (dilated) during cystoscopy
- open urethroplasty may be done for longer strictures
- if all else fails, a urinary diversion - appendicovesicostomy (Mitrofanoff procedure) - may be done; this allows self-catheterization of the bladder through the wall of the abdomen
- self catheterization may help to maintain urethral patency
- prognosis: repeated treatment may be needed to remove scar tissue
More general terms
Additional terms
References
- ↑ MedlinePlus: Urethral stricture http://www.nlm.nih.gov/medlineplus/ency/article/001271.htm
- ↑ Google Health: Urethral stricture https://health.google.com/health/ref/Urethral+stricture
- ↑ Mayo Clinic: Urethral stricture http://www.mayoclinic.org/urethral-stricture/
- ↑ The Center for Reconstructive Urology: Urethral Stricture http://www.centerforreconstructiveurology.org/urethralstricture/