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Urethral

stricture

Overview
Urethral stricture is an abnormal narrowing of the tube that carries urine out of the body from the bladder (urethra).

Symptoms
*Blood in the semen & Bloody or dark urine *Decreased urine output & Difficulty urinating *Discharge from the urethra & Frequent or urgent urination *Inability to urinate (urinary retention) & Incontinence *Painful urination (dysuria)

*Pain in the lower abdomen & Pelvic pain


*Slow urine stream (may develop suddenly or gradually) *Spraying of urine stream & Swelling of the penis

Treatment
The urethra may be widened (dilated) during cystoscopy by inserting a thin instrument to stretch the urethra while you are under local anesthesia. You may be able to treat your stricture by learning to dilate the urethra at home.If urethral dilation is not possible, you may need surgery to correct the condition. Surgical options depend on the location and length of the stricture. In cases of acute urinary retention, a suprapubic catheter may be placed as an emergency treatment. This allows the bladder to drain through the abdomen.There are currently no drug treatments for this disease. If all else fails, a urinary diversion appendicovesicostomy (Mitrofanoff procedure) -- may be done. This allows you to perform self-catheterization of the bladder through the wall of the abdomen.

Causes
*A history of sexually transmitted disease (STD) *Any instrument inserted into the urethra (such as a catheter or cystoscope) *Benign prostatic hyperplasia (BPH) *Injury or trauma to the pelvic area *Repeated episodes of urethritis Urethral stricture may be caused by inflammation or scar tissue from surgery, disease, or injury. It may also be caused by pressure from an enlarging tumor near the urethra, although this is rare. Other risks include:

Tests & diagnosis


*Decreased urinary stream & Discharge from the urethra *Enlarged (distended) bladder *Enlarged or tender lymph nodes in the groin (inguinal) area

*Enlarged or tender prostate


*Hardness (induration) on the under surface of the penis *Redness or swelling of the penis

*Cystoscopy & Post-void residual (PVR) volume


*Retrograde urethrogram & Tests for chlamydia and gonorrhea *Urinalysis & Urinary flow rate & Urine culture

Prognosis
Treatment usually results in an excellent outcome. However, repeated therapies may be needed to remove the scar tissue.

Prevention
Practicing safer-sex behaviors may decrease the risk of getting sexually transmitted diseases and urethral stricture. Treating urethral stricture quickly may prevent complications such as kidney or bladder infection or injury.

Complications
Urethral stricture may totally block urine flow, causing acute urinary retention. This condition must be treated quickly.

When to contact a doctor


Call your health care provider if symptoms of urethral stricture occur.