Urethral constriction by urological specialists

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A urethral narrowing (also known as urethral stricture or urethral stricture) usually occurs as a result of injuries or inflammation of the urethral mucosa, which have healed to form scar tissue. This scar tissue tends to grow and slowly spread in the urethra: Unfortunately, the disease is often progressive.


Most urethral constrictions occur in men (around 0.9% of the male population are affected); in women, the disease is rare but not excluded.


Urethral constrictions cause symptoms when urinating: The urine stream is thin and weak, it takes an unusually long time to urinate, the stream is often split and / or there is an uncontrollable dribble.


In addition, there is often the feeling of not being able to completely empty the bladder and complaints that arise from the residual urine remaining in the bladder: First and foremost, these are more frequent urination, deterioration in bladder functionality, tendency to urinary tract infections, possibly bladder stones. At an advanced stage, the backlog of urine can damage the kidneys. The extreme case of urethral constriction is complete urinary retention: a medical emergency.


The severity of the finding can be assessed with uroflowmetry (urine flow measurement), with contrast medium X-rays and / or a ureteroscopy. In this way, the diagnostic differentiation of bladder weakness, benign prostate enlargement and other diseases with comparable symptoms is made.


Treatment of the urethral narrowing is usually unavoidable. A newly diagnosed stricture is often treated with a urethral slit: To do this, an endoscope is pushed into the urethra as far as the constriction and the scar tissue is incised lengthways with a tiny scalpel inserted through the endoscope so that the urethral cross-section widens.


The problem with this procedure: the likelihood that a new urethral stricture will recur after several months is around 70% after the first incision and almost 100% after the second incision. This is because new scar tissue is created from the cut as it heals, which is very likely to take up even more space than what was originally there.


Repeated urethral slits are possible, but in the long term they almost certainly lead to a progressive worsening of the diagnosis. The chances of success of a urethral slit also depend on where exactly the constriction is located: the further “downstream” from the bladder the stricture is, the more likely it will relapse.


Treatment of urethral constriction must therefore be carefully considered. If urethral constrictions occur again, a more extensive urethral plastic surgery can be performed.


During urethral surgery, the entire extent of the scarred urethral mucous membrane is replaced by a healthy mucosal graft – this mucous membrane is generally removed from the mouth or foreskin. The prospects that urethral plastic surgery will cure the urethral constriction in the long term are much better; the relapse rate is less than 20%.


Short constrictions can also be treated with a so-called end-to-end anastomosis: The scarred piece is cut out of the urethra and the two free ends are connected again.


As urologo cdmx urological specialists are fully familiar with the diagnosis and treatment of urethral constrictions.

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