Urethra is the tube through which urine is discharged from the bladder. In men, urine pass through the lower surface of the penis, the same region that is used for ejaculation. In women, urethra is much shorter and ends just above the vaginal.
Stenosis occurs when the urethral diameter is reduced. Any portion of the urethra may be affected. Usually there is scar tissue around the affected area of the urethra causing the stenosis. The length of the stenosis varies from less than 1 cm to utmost the entire length of the urethra.
Common causes of urethral trauma (fall, kick, medical practice) and urinary infection (gonorrhea, chlamydia, chronic catheter use).
Note: most infections do not cause urethral stricture. Urethral narrowing is a possible complication of any urethral infection. Rarely, stenosis may be congenital and even more rarely result in malignancy.
The most common symptom is difficulty in urination and reduction of urine flow.
Other symptoms include urine “spraying” or disunity, urination frequency, pain in urination, frequent urinary tract infections and decreased force of ejaculation.
Urethral stenosis’ diagnosis is to measure the urine flow (a device called Uroflow System), and the urethral-cytoscopy, etc. Treatment is surgery performed either via the urethra using a urethro-scope (urethrotomy), or by open surgery (urethroplasty).
In urethrotomy, intersection along stenosis and lumen enlargement. With this procedure we have immediate relief of symptoms and about one in three cases will be completely cured. However, stenosis may again be repeated from time to time, in some cases.
Generally, the smaller the stenosis, the greater the likelihood of treatment with this process is. For example, a research study found that, when a urethrotomy was perfoed at stenosis of less than 2 cm, there was a recurrence of symptoms within 12 months at about 4 in 10 cases. However, there was a recurrence in 8 of 10 cases within 12 months when the stenosis was greater than 4 cm.
Urethroplasty generally has higher success rates.
The correction is made either by combining the healthy limbs using either skin or oral mucosa expanding the lumen of the urethra.