Urethral stricture: A difficult disease to treat, causing many troubles for men

The article is professionally consulted by Master, Doctor Vo Thien Ngon - Department of General Surgery - Vinmec Da Nang International General Hospital

Urethral stricture is a common urological disease, presenting after an infection or trauma to the urinary system. Urethral stricture disease affects the feeling and quality of love, making men no longer interested in sex, easily leading to impotence, premature ejaculation, infertility.

In the normal human body, there are usually two kidneys, responsible for filtering blood and excreting urine. Urine then flows down two ureters into the bladder. When the bladder contracts, urine is expelled through the urethra. The male urethra is longer than the female urethra because it runs an extra segment below the perineum and penis area, so it is more susceptible to injury.
Urethral stricture is the narrowing of the urethra due to inflammation or any other problem. The urethra is responsible for carrying urine out of the body. In a person with urethral stricture, urine flow is usually weak or double flow may occur. Severe urethral stricture can completely block urine flow.
Urethral stricture disease has a profound effect on the patient's life, causing a feeling of difficulty urinating - urinary retention, fluid retention - cystitis, even kidney failure, infertility if not treated properly, and prolonged illness. long.

Urethral stricture is often the result of an episode of urethritis. Because gonococcal bacteria hide and cause disease, long-term scarring causes narrowing of the urethra in many places; Because infection of the foreskin often occurs post-coital cross-contamination, narrowing and possibly spreading to the prostate and bulbar urethra; Due to the systemic disease, lesions of renal tuberculosis, bladder tuberculosis then spread to urethral tuberculosis. Urethral stricture is also due to sequelae of urethral trauma; after procedures to remove urethral stones that damage the urethral mucosa, after surgery to remove prostate fibroids.

Symptoms of urethral stricture in men can range from mild discomfort and to urinary retention, including the following:
Difficulty initiating urination; Pain when urinating (dysuria); Urinary tract infection (UTI); urinary retention; The bladder is not completely empty; Weak flow; Urine drip; Urine spray or double stream; Blood in the urine (hematuria); Blood in semen; Urinary incontinence; Pelvic pain; Decreased ejaculatory force. There may be other symptoms and signs of urethral stricture not mentioned.

After urethral stricture, you still endure, try to urinate naturally for a while, depending on the extent of damage, progress to complete stenosis. Endurance, trying to urinate naturally gradually leads to complications. Stagnation of bladder urine causes infection upstream to the ureters and kidneys. Due to long-term stagnation there is no way out, causing leakage into the skin at the location of the perineum or scrotum and stagnation with infection forming a honeycomb-shaped abscess, causing the formation of a bladder diverticulum and long-term. complications of renal failure.

Based on the test results, the doctor can dilate the urethra, cut the narrow section with laser or endoscopic cutter, place a stent, have an anastomosis surgery using skin flaps or grafts.
5.1. Urethral dilation Usually performed in the clinic. After local anesthesia, the doctor will use dilatations with increasing size to widen the urethra. In addition, the urethral stricture can also be dilated with a special balloon on the catheter. Urethral dilation usually does not completely resolve this pathology so it must be performed repeatedly. The procedure can cause pain, bleeding, and infection.
5.2. Urethrectomy (stricture resection) This procedure uses a specially designed bronchoscope to be inserted into the urethra until the stricture is reached. Then, a blade or fiber laser is used at the end of the scope to cut the narrow segment. A catheter is placed into the urethra for a period of time until the wound heals. The timing of catheter removal after surgery depends on the patient's response status.

5.3. Urethral stenting This procedure places a metal stent into the urethra using a specially designed scope. The advantage of this method is that it is minimally invasive, but it is only suitable for very few cases.
5.4. Urethral reconstruction Many different surgeries are used to reconstruct the urethra . There is no single surgery that is appropriate for all situations, depending on the characteristics of the stricture and the experience of the surgeon. With a short narrow section, surgery can be performed to cut the two ends (urethroplasty anastomotic). When the stenosis is long or cannot be anastomosed, a tissue tissue can be transferred to widen the stenosis (tissue replacement surgery).
To prevent urethral stricture in men, doctors say the most important thing is to prevent damage to the urethra and pelvis. If you are self-catheterizing, use lubricant and use the smallest catheter to avoid injuring the urethra.
Urethral stricture can be complicated if you have a sexually transmitted infection like gonorrhea and chlamydia. At that time, timely and adequate treatment of the disease with antibiotics will help prevent this complication.
For any questions about urethral stricture, please come directly to Vinmec International General Hospital or contact HERE for answers.
Doctor Vo Thien Ngon has over 7 years of experience working as a urologist and surgeon at Hospitals: Hue Central Hospital, Hue University of Medicine and Pharmacy Hospital, Tam Tri Da Nang General Hospital .
Doctor Ngon with the ability to specialize in the field of examination and treatment of diseases of the Urology and Andrology system, Urology surgery, endoscopic urological surgery, Laparo urinary tract surgery, endoscopy Urinary. Currently, Dr. Vo Thien Ngon is a Urology - Orthopedic Surgery Doctor, Department of General Surgery, Vinmec Da Nang International Hospital