Urethral Stricture Treatment in Tilghman, MD
Do you have painful urination, frequent urinary urges, or pelvic pain? It may be urethral stricture, a narrowing of your urethra that can occur after infection or injury. Usually affecting men, strictures can affect the flow of urine, causing painful or decreased urination.
While urethral stricture can make urinating painful, surgery can help relieve your symptoms. To speak with a urethral stricture specialist today in Tilghman, call (410) 266-3613 or contact Dr. Alan Stuart Weiss online
What are the symptoms of urethral stricture?
You may not experience any symptoms of urethral stricture. If you do, symptoms of urethral stricture can include:
- painful urination (dysuria)
- difficulty beginning urination (hesitancy)
- a more-frequent urge to urinate
- decreased or dribbling urine
- incomplete emptying of the bladder
- abdominal or pelvic pain
- urinary incontinence
Symptoms specific to men can include reduced ejaculation, bloody semen, and swelling of the penis. In extreme cases, you may experience:
- the complete inability to urinate (urinary retention)
- urinary tract infection (UTI)
- urethral cancer
- the swelling of one or both kidneys from fluid build-up (hydronephrosis)
- renal failure
If you experience any of these symptoms, contact your healthcare provider right away - urinary retention is a medical emergency.
What causes urethral stricture?
Urethral stricture usually affects men and is rare in women. Conditions that cause the scarring and narrowing of urinary retention include:
- trauma to the urethra or bladder from injury or accidents
- fracture of the pelvic bones
- infection from a sexually transmitted disease (STD) like gonorrhea or chlamydia
- long-term use of catheters (tubes inserted in the urethra to drain the bladder)
- urethra surgeries
- placing objects into the urethral opening as part of sexual play (wanding)
- kidney stone removal
- prostate infection or inflammation (prostatitis)
- surgery to remove an enlarged prostate gland
- urethra or prostate cancer
- radiation therapy
How is urethral stricture diagnosed?
Tests that can be used for the diagnosis of urethral stricture include:
- physical exam with a review of your symptoms and medical history
- obtaining a sample of urine to test for signs of infection (urine culture)
- ultrasound of the urethra
cystourethroscopy, where a small, bendable, viewing instrument with a light at the end of it (cystoscope) is inserted into the urethra to view the narrowed area
- urethroscopy, which is similar to a cystourethroscopy but uses a longer and thinner ureteroscope
retrograde urethrogram, when contrast dye is injected into your urethra at the tip of the penis to allow your provider to see the narrowing with an x-ray
- an antegrade urethrogram or antegrade cystourethrogram is used if you have a suprapubic catheter placed in your bladder through your abdominal skin; the contrast dye is injected into the bladder through this catheter
- cystography filling and voiding (VCUG), when you drink water to fill your bladder and then urinate under fluoroscopy (continuous x-ray imaging)
- MRI or CT scan to identify pelvic fractures
- STD Testing
How is urethral stricture treated?
To date, these surgical procedures have been used to treat urethral stricture:
- urethral stricture dilation: enlarging the stricture with gradual stretching with devices called sounds or with balloons on catheters; you may need to use a catheter from time to time to prevent narrowing
urethrotomy: using a cystoscope to identify the narrowing, and cutting the stricture with a laser or knife; a catheter may be used to hold the gap open and let it heal
- direct vision internal urethrotomy (DVIU) is a type of urethroplasty, when a surgeon cuts the stricture lengthwise to open up it, widen the urethra, and hold it in place with a catheter for a week of healing
- a perineal urethrostomy involves opening the urethra and sewing it to the area between the anus and scrotum (perineum)
Open surgery can also be used to remove the stricture and reconnecting and reconstruct the urethra (urethroplasty). There are two main types of open surgery; anastomotic urethroplasty and substitution urethroplasty:
anastomotic urethroplasty: used for short strictures, a cut is made between the scrotum and rectum, and the stricture is removed and the urethra reconnected
- a common example is excision and primary anastomosis urethroplasty
substitution urethroplasty: used to treat long strictures, where tissue is used to replace the affected urethra
- free graft: uses tissue like skin from the shaft of the penis or buccal mucosa from the inside of the cheek; requires a hospital stay and catheter use for two to three weeks
- skin flap: flaps of skin are rotated from the penis to create the new section of the urethra; requires a hospital stay and catheter use for two to three weeks
- staged: used if tissue cannot be transferred, and is separated into two stages; during the first stage, a graft is secured to the urethra for three months to a year; in the second stage, the graft is formed into a tube
These methods typically produce similar success rates.
The surgery used for your specific case will depend on the size of the blockage and the amount of scar tissue. Urethral stricture surgery recovery time will also depend on the same factors. Side effects of these treatments can include bleeding and infection.
Urethral reconstruction is one of the great surgical challenges for urologists. A cell-based tissue-engineered urethra may be an alternative for patients who have complicated long strictures and need urethral reconstruction. Studies have demonstrated the feasibility of using autologous urine-derived stem cells (USCs) to repair a urethral defect in a rabbit model. Tissue engineering (the regeneration of tissue from cells, biomaterials, scaffolds, and stem cell growth factors) is a promising solution.1
As with any medical procedure, results of these treatments will vary from patient to patient, depending on age, genetics, environmental conditions, and other health factors.
Men who are looking for more natural ways to treat their urethral stricture include bee pollen, which has been found to support urinary health and may relax the muscles in the lining of the urinary tract.
You may prevent urethral stricture by wearing condoms to avoid STDs. Practicing safe self-catheterization, such as using plenty of lubricating jelly with the smallest catheter for the shortest time, can also help you prevent stricture.
Reserve your appointment now
Urinary tract narrowing and scarring can cause many serious conditions that affect your daily life. If you have symptoms of urethral stricture, seeing a specialist can help relieve or reduce these symptoms and improve your quality of life.
1. Cheng, Li et al. "A Brief Review on Anterior Urethral Strictures." Asian Journal of Urology 5.2 (2018): 88–93. PMC. Web. 5 July 2018.
Annapolis Integrative Medicine
Address1819 Bay Ridge Ave
Annapolis, MD 21403