Causes of urethral stricture
- 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.
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.
- Urinalysis and culture and sensitivity
- Urea and electrolytes
- Micturating cystourethrogram and ascending urethrogram
- 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.