Stricture Urethra/Urinary Strictures

Urinary Strictures or Stricture Urethra refer to the narrowing or obstruction of the urinary passage/urethral tube in which urine flows outside the body. It occurs when an infection, injury, or swelling develops a scar and slows or completely restricts urine flow in the tube connecting the bladder to the urethra. This urological condition can be unpleasant for some people and, if left untreated, can cause kidney damage. That is why it is critical to seek urethral stricture treatment as soon as you notice its initial symptoms. 

Stricture urethra is more common in men, which could be because they have a longer urethra than women. It is uncommon for females, especially those with significant lower urinary tract symptoms, to have stricture urethra.

Causes of Stricture Urethra

The urethra is frequently constricted and narrowed due to tissue inflammation or the development of scar tissue. Scarring of urethral tissues and subsequent restriction in urine flow can happen due to many reasons. These include:

• A straddle injury or trauma/injury to the pelvis or urethra of an individual 
• Prostate cancers in men or malignancies of the urethra 
• Sexually transmitted infections
• Having penile implants 
• Recent hypospadias surgery by a young man to address his underdeveloped urethra
• Radiation therapies
• An enlarged prostate or previous surgery for treating an enlarged prostate 
• Long-term or intermittent use of a urinary catheter
• Removal of kidney stones
• Surgical tool abrasion or undergoing a medical procedure involving a surgical instrument like an endoscope into the urethra
• Perineum or scrotum injuries from a fall.

With proper initial diagnosis and treatment, urethral stricture can be effectively managed or cured. If you are experiencing the symptoms mentioned above and seek an improved quality of life, you can consult the Best Doctors for Urethral Stricture Treatment in Hyderabad at Arete Hospitals.

Signs and Symptoms of Urethral Stricture

Urethral strictures can induce various symptoms ranging from moderate to severe. Among them, the warning symptoms are:

• Weak urine flow or a decrease in urine volume
• Urge to urinate frequently and suddenly
• Interruptions in the urinary stream 
• A sensation of inadequate bladder emptying following urination
• Urinary discomfort or burning sensation felt while passing urine
• Urinary incontinence
• Penile swelling and discomfort
• Pain felt in the pelvic or lower abdominal region
• Discoloured urine
• Blood in urine
• Urinary discharge
• Inability to urinate- a dangerous condition requiring emergency medical intervention.

Stricture Urethra Treatments

Numerous treatments are provided by Top Urethral Stricture Surgeons in Hyderabad based on the size of the blockage and the amount of scar tissue involved. There are no medications available to treat strictures. Patients will continue to have voiding issues if they do not seek treatment. Infections and stones in the urinary tract or testicles are possible. There is also a risk of urinary retention (inability to pass pee), which can lead to an enlarged bladder and kidney problems. 

Treatment options include:

1. Dilation

It is commonly performed under local anaesthesia by an experienced urologist. The urethral stricture is stretched using increasingly large dilators known as "sounds." A catheter with a specific balloon can also stretch the tissue. However, stretching is not a cure and must be done regularly. If the stricture returns too soon, patients may be taught to insert a catheter regularly to keep it from returning. Bleeding and infection are possible side effects. Stretching can result in the formation of a "false passage" or second urethral channel.

2. Urethrotomy

A cystoscope is used by the urologist to go along the urethra until the stricture is detected. The cystoscope's knife blade or laser removes the stricture and creates a space. A catheter can be inserted into the urethra to keep the gap open and allow it to heal. The stricture length determines how long a catheter tube should remain in place for urine drainage.

3. Open surgery

Many reconstructive strategies are available for Urethral Stricture Disease Treatment in Hyderabad. Some people may be needing only one or two surgeries. In all situations, the type of repair is determined by the stricture's location, length, and severity. No single fix is appropriate in all circumstances. Two basic surgical approaches include:

• Anastomotic urethroplasty: It is typically used for short urethral strictures. In this case, a cut is made between the scrotum and the rectum. After the stricture has been removed, the remaining parts of the urethra are joined. This is often done as an outpatient procedure or with a brief hospitalisation. For 10 to 21 days, a tiny, soft catheter is left in the penis. It is then removed following an X-ray to ensure the repair has healed.
• Substitution of urethroplasty: When the stricture is complex, tissue can be transferred to replace the area that has been damaged. Substitution repairs may need to be done in stages in complex situations. A urologist who is familiar with these repairs should perform these repairs. Overall, the success rates are excellent. 

There are three types of substitution procedures:

1. Free graft: The procedure uses autologous tissue to replace or expand a piece of the urethra. The tissue may be taken from the cheek's buccal mucosa or the skin that lines the penis shaft. Patients may require a short hospital stay and a catheter for two to three weeks following surgery.

2. Skin flap:  Skin flaps are pieces of skin rotated from the penis to create a new part of the urethra. It is required when there is a need for long graft, and the stricture is severe. This treatment is complex and should only be performed by a plastic surgeon. Following surgery, patients may require an overnight hospital stay and a catheter for two to three weeks.

3. Staged: This procedure is used when local tissue cannot be used for a free graft or a skin flap.

(a) First stage: The urethra's underside is opened, revealing the whole length of the stricture. The opening urethra is secured with a graft. The graft takes 3 months to a year to heal and develop. Patients will urinate through a new opening behind the stricture at this time. It may necessitate sitting down to urinate while the graft heals.

(b) Second stage: The graft is soft and flexible and is moulded into a tube several months after the graft surrounding the urethra has healed. After that, the urethra returns to normal. For 10 to 21 days, a tiny, soft catheter is left in the penis.

After Stricture Urethra Treatment

Because urethral strictures sometimes recur after surgery, patients should see a urologist. After removing the catheter, the doctor will want to check patients with physical tests and X-rays. To check the repair, the doctor may do a urethroscopy. The stricture may sometimes recur, but no further treatment is required. However, urethrotomy or dilatation can be used to treat it if it causes obstruction. If severe strictures recur, open surgery may be necessary again.