What is a urethral stricture and what causes it?
Guest Post about: urethral stricture
A urethral stricture may be congenital. It is a congenital alteration of the urethra, which is triggered by so-called urethral valves or hypospadias. On the other hand, a urethral stricture can occur after injury to the urethra. This happens when scars that cause narrowing. Such injuries can occur, for example, in endoscopic procedures such as cystoscopy. Such trauma is however extremely rare. In most cases, these interventions are unproblematic and do no harm. Other causes are possible. Thus, a urinary catheter rise to complaints or a dull trauma in the area of the dam. The urethra is injured by externally applied pressure. This may be the case, for example, while riding or cycling.
Patients with fractures in the pelvic area are also at risk for a urethral stricture. Depending on the severity of a pelvic bone fracture, it may even come to the demolition of the urethra from the bladder and prostate. In such cases there is a danger of a complete closure of the urethra.
Other possible causes include inflammation (urethritis) or sexual disorders. But foreign bodies, tumors and benign prostate enlargement can lead to a narrowing of the urethra and the complaints.
What symptoms occur in a urethral strictures?
Other symptoms that occur of a bladder infection in their characteristics are very similar. These include increased urinary frequency and difficult urination. But uncontrolled urination (urinary incontinence) or UTIs occur again and again in connection with a urethral stricture on. Not infrequently, the feeling comes to the bladder can not empty completely, which is perceived by stakeholders to be extremely unpleasant.
If these symptoms occur, consulting a physician is essential. This will decide on the basis of various studies, if a narrowing of the urethra, or an infection in the bladder is present. From this, the symptoms can be treated.
How is a urethral stricture diagnosed?
From these results, discusses the urologist with the patient’s treatment options.
How is it treated a Harnöhrenverengung?
So there are four different treatment methods that play a role in a urethral stricture.
1. Harnröhrenschlitzung: With the so-called urethrotomy especially stricture in scarring over short distances are treated. The scar is considered in more detail as part of a urethra Reflection and cleaved using the finest instruments. This requires a short anesthesia is necessary, which is well tolerated as a rule by the patient. During surgery, a urinary catheter is placed, which still needs to be worn for some time. The disadvantage of treatment is, however, that it has a high relapse rate and it is successful in only half of cases.
2. urethral stent: In this method, a thin, stretchable tube is inserted from a weave of plastics or metal in the urethra. This tube is called a stent and has an object to overcome the constriction and to support the urethra. Here also follows an endoscopic surgery, however there’s no lasting success. In some cases, the scar tissue expands through the meshes of the stent. It can also lead to infection, which are to combat difficulties permanently. This method is therefore rarely used.
3. Harnröhrenaufdehnung (-bougierung): With special urethral catheters, which are called bougie à boule pins, is expanded, the urethral stricture in this method. It is a very simple solution that is made to the urologist. Depending on the case, it is possible for the patient, this self-made home. Nevertheless, the treatment should be done under medical supervision, since it requires frequent repetition and the results are not permanent. The relief of symptoms is therefore given only for a certain period. In addition, it may cause injury to the urethra in this case, the worse the narrowing in the long run. For these reasons, this method is used only in exceptional cases.
4. urethra Construction: With strictures, which extend over a greater distance and recur, there is only one treatment option. Here, a urethroplasty, or a urethral replacement is used. Operationally eliminates the surgeon’s throat after he exposed the urethra. One way to do this is the end-to-end anastomosis, the pieces removed from the urethra and the ends are connected again. If it is a longer distance or more parts have to be cut, a urethroplasty is used. For this purpose, typically the patient’s tissue is used. Often this Mundscheimhauttransplantat is used. Only in rare cases to use Physicians foreign tissue.
Compared to other methods is here to anticipate a much higher chance of success. She is up to 95%, but depends largely along with the experience and skill of the surgeon. In addition, an appropriate follow-up is vital to the later stages.