Urethral Strictures in Males
The tube that carries urine out of the body from the urinary bladder is called as urethra. Any abnormal narrowing of this tube is called as urethral stricture. Although it can be found both in males and females, the condition somehow has a predilection for males.
Causes of urethral strictures:
The common causes for the development of urethral stricture in males are:
- Any inflammation or scar tissue resulting from injury, disease or surgery.
- Pressure on the urethra from a tumor growing in its vicinity.
- Trauma during catheterization or cystoscopy
- Sexually transmitted diseases
- Repeated inflammation of the urethra, also called as urethritis.
- Injury in the pelvic region. According to the Center for Reconstructive Urology, straddle injury resulting from falling off a bicycle or getting hit in the scrotum is one of the most common injuries that may lead to urethral strictures.
- Benign prostatic hypertrophy.
- Congenital urethral strictures.
- Hypospadias surgery to correct underdeveloped urethra in young boys.
- Penile implantation surgery.
- Radiation to treat tumors in the neighborhood of urethra.
- Pelvic fractures are also a common cause of urethral strictures in males.
Symptoms of urethral strictures in males
Some of the common symptoms seen in men suffering from urethral strictures include:
- Abnormal discharge from the mouth of the urethra.
- Blood in the urine.
- Blood in the semen.
- Increased frequency of urination.
- Urgency to urinate.
- Pain during voiding urine
- Reduced output of urine associated with urinary retention in the bladder.
- Reduced control of bladder.
- Pain in the lower abdomen and pelvis.
- Interrupted stream of urine.
- Swelling of the glans of the penis.
- In extreme cases, the patient may be completely unable to pass urine.
Diagnosis of urethral strictures in males
Based on the patient’s medical history and physical examination, the doctor may suspect urethral strictures. However, to confirm the diagnosis, several tests are performed. These include:
- Urodynamic studies
- Urine analysis
- Measuring the size of the urethral meatus.
- Testing for sexually transmitted diseases like gonorrhea and chlamydia
Treatment of urethral strictures in males
The most basic treatment for urethral strictures in men comprises of using dilators. This is an outpatient procedure wherein dilators of increasing diameter are successively introduced into the urethra. As they pass through the urethra, these dilators gradually increase its width. In some cases, an indwelling catheter is left in the urethra. However, this is generally not preferred as it increases the chances of urinary tract infections.
If dilators are not very successful in breaking the strictures, a surgery called as urethroplasty is performed. The area in which the strictures are present is surgically removed and the urethra is reconstructed.
If urethroplasty also fails to relieve the strictures, the urine flow is diverted as a last resort. In this procedure, a catheter may be introduced into the bladder and the urine is drained through the abdomen.
Prognosis of urethral strictures in males
The condition is usually resolved with the abovementioned methods. However, sometimes there may be a need to repeat the treatment because of development of scar tissue.
Possible complications of urethral strictures in males
Sudden acute urinary retention is the most serious complication of urethral strictures. It is an emergency situation that needs to be dealt on an urgent basis.