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Urethral Stricture

Urethral stricture is a medical condition characterized by the narrowing of the urethra, the tube responsible for carrying urine from the bladder to the outside of the body. This narrowing restricts urine flow, causing discomfort and potential complications like urinary retention, infections, or bladder stones. Urethral stricture can affect men more commonly than women, with causes ranging from trauma and infections to previous surgeries.

The condition varies in severity, and treatment options depend on the location, length, and underlying cause of the stricture. Below, we explore the main treatment modalities, including both minimally invasive and surgical approaches.

What is Urethral Stricture

A urethral stricture occurs when scar tissue develops in or around the urethra, reducing its diameter. The primary causes include:

• Trauma: Direct injury to the urethra, such as pelvic fractures or catheterization.

• Infections: Chronic or untreated urinary tract infections, including sexually transmitted infections.

• Surgeries: Complications from prostate or bladder surgeries.

• Congenital Conditions: Some individuals are born with structural abnormalities that predispose them to strictures.

Common symptoms include:

• Weak urine stream or spraying.

• Difficulty starting urination or a sense of incomplete emptying.

• Frequent urinary tract infections.

• Pain during urination or ejaculation.

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Treatment Options for Urethral Stricture

1. Open Surgery: Urethroplasty

Overview:

Urethroplasty is considered the gold standard for treating long or complex urethral strictures. It involves reconstructing the urethra to restore its normal function.

Types of Urethroplasty:

• End-to-End Urethroplasty: In cases of short strictures, the damaged section is excised, and the healthy ends of the urethra are sutured together.

• Substitution Urethroplasty: For longer strictures, tissue grafts (often harvested from the inner cheek or other parts of the body) are used to rebuild the urethra.

Advantages:

• High success rate, often exceeding 90%.

• Provides a permanent solution with low recurrence.

• Suitable for severe or recurrent strictures.

Recovery:

Patients typically require a catheter for a few weeks post-surgery, followed by a gradual return to normal activities.

2. Closed Surgery: Internal Urethrotomy

Overview:

Internal urethrotomy is a minimally invasive procedure where a small incision is made in the scar tissue using a specialized scope inserted into the urethra. This widens the narrowed area, allowing for improved urine flow.

Procedure:

• Performed under local or general anesthesia.

• A thin, flexible instrument with a blade or laser (urethrotome) is used to cut through the stricture.

• Often followed by catheter placement to ensure…