Summary about Disease
Urethral stricture is a narrowing of the urethra, the tube that carries urine from the bladder out of the body. This narrowing restricts the flow of urine and can lead to various urinary problems. The stricture is usually caused by scar tissue formation from injury, infection, inflammation, or medical procedures.
Symptoms
Symptoms of urethral stricture can vary depending on the severity of the narrowing. Common symptoms include:
Weak urine stream
Straining to urinate
Frequent urination
Urgency
Incomplete bladder emptying
Painful urination
Spraying of the urine stream
Blood in the urine or semen
Urethral discharge
Recurrent urinary tract infections (UTIs)
Inability to urinate (urinary retention)
Causes
The most common causes of urethral stricture are:
Injury: Trauma to the urethra, such as from a straddle injury, pelvic fracture, or catheterization.
Infection: Sexually transmitted infections (STIs) like gonorrhea and chlamydia can cause inflammation and scarring.
Inflammation: Conditions like lichen sclerosus (balanitis xerotica obliterans) can affect the urethra.
Medical Procedures: Instrumentation of the urethra, such as cystoscopy or transurethral resection of the prostate (TURP), can sometimes lead to stricture formation.
Unknown Cause (Idiopathic): In some cases, the cause of the stricture is unknown.
Congenital: Rarely, urethral strictures are present at birth.
Medicine Used
Medications play a limited role in directly treating urethral strictures. The primary treatment options are surgical. However, medication might be used to manage related symptoms or conditions:
Antibiotics: Used to treat urinary tract infections (UTIs) that may result from the stricture.
Alpha-blockers: May be prescribed to help relax the muscles in the prostate and bladder neck, potentially improving urine flow in some cases. (not directly related to stricture treatment, but symptom management)
Analgesics (Pain relievers): Over-the-counter or prescription pain relievers may be used to manage pain associated with urination or other symptoms. Note: Medications will not fix the stricture. Surgical interventions are typically required.
Is Communicable
Urethral stricture itself is not communicable. However, if the stricture is caused by a sexually transmitted infection (STI), such as gonorrhea or chlamydia, the STI itself is communicable and can be transmitted through sexual contact.
Precautions
Safe Sex Practices: Practice safe sex to prevent STIs that can lead to urethral strictures.
Careful Catheterization: If catheterization is necessary, ensure it is performed carefully and by experienced medical personnel.
Prompt Treatment of UTIs: Seek prompt medical attention for urinary tract infections to prevent complications.
Avoid Urethral Trauma: Take precautions to avoid injuries to the urethra.
Regular Check-ups: If you have a history of urethral stricture or risk factors, consider regular check-ups with a urologist.
How long does an outbreak last?
Urethral stricture is not an "outbreak" in the typical sense of an infectious disease. It's a chronic condition. Once a stricture develops, it typically persists and may worsen over time if left untreated. Symptoms may fluctuate in intensity, but the underlying narrowing remains.
How is it diagnosed?
Urethral stricture is diagnosed through a combination of:
Medical History and Physical Exam: The doctor will ask about symptoms and medical history.
Urine Flow Rate (Uroflowmetry): Measures the speed and volume of urine flow.
Post-Void Residual (PVR): Measures the amount of urine left in the bladder after urination.
Urethroscopy: A thin, flexible scope with a camera is inserted into the urethra to visualize the stricture directly.
Retrograde Urethrogram (RUG): X-ray of the urethra taken while contrast dye is injected into the urethra.
Voiding Cystourethrogram (VCUG): X-ray taken while urinating after filling the bladder with contrast dye.
Timeline of Symptoms
The timeline of symptoms can vary.
Initial Injury/Event: An injury, infection, or procedure occurs that damages the urethra.
Inflammation and Scarring: Over time (weeks to months), inflammation leads to scar tissue formation.
Gradual Narrowing: The urethra gradually narrows as the scar tissue contracts.
Symptom Onset: Symptoms such as weak stream, straining, and frequency begin to appear, usually gradually.
Progression: Without treatment, the stricture may worsen, leading to more severe symptoms and complications. Symptoms might fluctuate in intensity, but the underlying stricture is a chronic process.
Important Considerations
Early Diagnosis and Treatment: Early diagnosis and treatment can help prevent complications such as urinary retention, bladder damage, and kidney problems.
Recurrence: Urethral strictures can recur even after treatment. Regular follow-up with a urologist is important.
Treatment Options: The best treatment option depends on the length, location, and severity of the stricture.
Psychological Impact: Urethral stricture can have a significant impact on quality of life. Support and counseling may be helpful.
Long-term follow up: Essential to monitor recurrence rates.