Urethral strictures in men
A stricture is a band of scar tissue that causes a blockage. This may be caused by trauma to the urethra (a fall or accident where the perineum is injured), infections or often no cause is discovered. The narrowing or blockage of the urethra makes passing urine difficult and can make the stream of urine very slow.
If you have symptoms; such as slow urinary stream and straining to empty the bladder your Urologist will arrange a number of tests to confirm the diagnosis. This may include an ultrasound scan to access the bladder and prostate, a flow rate test (you will be asked to pass urine into an apparatus that measures the time it takes to empty the bladder) and a urethrogram (where a small catheter is inserted into the tip of the penis and dye is injected into the urethra to give an outline of the urethral lining).
The treatment for a stricture will vary depending on a number of factors, including the patient’s age, whether they have had treatment for a stricture previously and the length and location of the narrowing within the urethra.
Cystoscopy and dilatation of stricture:
After an anaesthetic is given, a telescope is passed down the urethra to the point of narrowing. A flexible wire is then passed through the narrow point and a series of dilators are passed over the wire to stretch the scar tissue. The telescope is then passed through the urethra to the bladder. It may be necessary to leave a catheter tube in after the procedure, depending on the circumstances.
If a stricture has recurred despite dilatation or if it involves a long segment in the urethra it may be necessary to remove the area of scarred tissue and reconstruct the urethra. The operation required will depend on the length and location of the stricture. In some cases the scar tissue can be cut away and the urethra re-joined, in other cases a small piece of tissue from the lining of the cheek (buccal mucosa) or a piece of skin is used to reconstruct the urethra. After the operation, a catheter will be placed to drain the bladder and allow the urine to drain passed the healing tissue. This will be removed after a special Xray (peri-catheter urethrogram) to check the repair is watertight.