Urethral Stricture is an abnormal narrowing or loss of distensibility of any part of the urethra, as a result of fibrosis.
It is one of the commonest causes of urine retention in tropical Africa.
It is very rare in females.
It may result from trauma or inflammation; it may equally be iatrogenic.
Causes of urethral stricture
1. Traumatic causes:
- Penetrating or blunt injury to the urethra
- From pelvic fractures or falling astride an object
2. Infective causes:
- Gonococcal urethritis or non-gonococcal urethritis from chlamydia, tuberculosis or schistosomiasis
3. latrogenic causes:
- Urethral instrumentations e.g. catheterization and urethroscopy
- It may be congenital
- May be complete or partial, single or multiple
- Can affect any part of the urethra, anterior or posterior
Symptoms and clinical features of urethral stricture
- Poor stream
Examination of the external genitalia may reveal:
- Urethral indurations.
- Periurethral or perineal abscess
- Urinary fistula
- Benign prostatic hypertrophy
- Prostate cancer
- Bladder calculi
- Bladder neck stenosis
Complications of urethral stricture
- Urethral/bladder calculi
- Urinary tract infections
- Urinary retention
- Perineal urinary fistulae
- Progressive renal failure
- Fournier’s gangrene
- Urine microscopy, culture and sensitivity
- Serum Urea, Electrolytes and Creatinine
- Abdominal ultrasound
- Full Blood Count
Treatment for urethral stricture
- To restore urethral patency
- Serial dilatation/bouginage
- Endoscopic direct visual urethrotomy
- Urethroplasty: excision and end-to-end anastomosis
- Substitution urethroplasty
- Ensure prevention of sexually transmitted infections.
- Prompt and appropriate treatment of sexually transmitted infections
- Care and attention to asepsis during instrumentation procedures involving the urethra