URETHRAL STRICTURE

Causes of urethral stricture

  • Congenital
  • Traumatic (usually follows fracture of pelvis)
  • Inflammatory (follows gonorrhoea infection, usually earlier in life)
  • instrumentation that results from indwelling catheter following endoscopy or postoperatively following prostatectomy or after amputation of penis.

Clinical Features

Usually occurs in younger patient (below 50 years).

Early symptoms include
  • Passage of flakes in urine with early morning urethral discharge
later symptoms include
  • Difficulties in micturition (narrow prolonged stream, dribbling, straining).
  • There is urine retention with a distended urinary bladder.
  • History of urethral discharge in the past, history of pelvic injury, and history of instrumentation are significant.
  • The urethra should be palpated for induration
  • A rectal examination performed on all patients.

Investigations

  • Urinalysis and culture and sensitivity
  • Urea and electrolytes
  • Micturating cystourethrogram and ascending urethrogram

Management

  • Carry out suprapubic cystostomy or insert cystofix if there is retention of urine
  • Conduct basic investigations as above and treat for urethral discharge before any treatment.
  • Definitive surgical treatment.