A urethral stricture involves scarring that narrows the tube that carries urine out of your body (urethra). A stricture restricts the flow of urine from the bladder and can cause a variety of medical problems in the urinary tract, including inflammation or infection.
To make a diagnosis, the IWI team will ask about your symptoms and your medical history and conduct a physical exam. Your doctor might recommend a number of tests to determine the cause, location and length of the urethral stricture, including:
Catheterization. Inserting a small tube (catheter) into your bladder to drain urine is the usual first step for treating urine blockage. We might also recommend antibiotics to treat an infection, if one is present. Self-catheterization might be an option if you’re diagnosed with a short stricture.
Dilation. Dr. Guerette gently inserts a tiny instrument through the urethra and into the bladder. Progressively larger dilators pass over to gradually increase the size of the urethral opening. This outpatient procedure may be an option for recurrent urethral strictures.
Urethroplasty. This involves surgically removing the narrowed section of your urethra or enlarging it. The procedure might also involve reconstruction of the surrounding tissues. Tissues from other areas of the body, such as your skin or mouth, may be used as a graft during reconstruction. The recurrence of urethral stricture after a urethroplasty is low.
Endoscopic urethrotomy. For this procedure, Dr. Guerette inserts a thin optical device (cystoscope) into your urethra, then inserts instruments through the cystoscope to remove the stricture or vaporize it with a laser. This surgical procedure offers a faster recovery, minimal scarring and less risk of infection, although recurrence is possible.
Implanted stent or permanent catheter. If you have a severe stricture and choose not to have surgery, you may opt for a permanent artificial tube (stent) to keep the urethra open, or a permanent catheter to drain the bladder. However, these procedures have several disadvantages, including a risk of bladder irritation, discomfort and urinary tract infections. They also require close monitoring. Urethral stents are often a measure of last resort and are rarely used.
Generally, whenever urethroplasty is possible for treating urethral stricture, Dr. Guerette prefers that procedure over other surgical treatments. Performing urethroplasty early during the course of treatment spares you from needing multiple endoscopic urethrotomies, if urethral stricture recurs
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