Urethral stricture

　　What are the causes of urethral stricture? Urethral stricture is a common disease of the urinary system, more common in males. Regarding the causes of urethral stricture, we can look at its three types. The etiology of urethral stricture can be divided into three categories: congenital urethral stricture, traumatic urethral stricture, and inflammatory urethral stricture. What are the causes of urethral stricture? The following will introduce it to everyone.

　　Commonly found in the urethral orifice with stricture, often accompanied by phimosis or phimosis. The urethral orifice of urethral cleft or urethral cleft is also often narrower than normal. The etiology of urinary tract stricture can be divided into three categories, which will be introduced to everyone below.

　　First, congenital urethral stricture:

　　Such as urethral orifice stricture, urethral valve, etc.

　　Second, traumatic urethral stricture:

　　The most common, due to severe urethral injury, improper initial treatment, or not in time. The degree, depth, and length of stricture vary greatly in pathology, usually only one stricture, while gonococcal stricture may be multiple stricture. Stricture may be secondary to infection, forming urethral diverticula, perineal urethritis, prostatic or epididymal orchitis.

　　Third, inflammatory urethral stricture:

　　Such as gonococcal urethral stricture, in addition, indwelling catheters can also cause urethral stricture.

　　Feihua Health Network experts introduce:

　　Urethral stricture is commonly seen in clinical practice, including congenital urethral stricture such as congenital urethral orifice stricture, urethral valve, seminal plate hypertrophy, congenital urethral lumen stricture, etc. Inflammatory urethral stricture often occurs due to urethral lumen infection and injury. Traumatic urethral stricture is often caused by improper initial treatment. The degree, depth, and length of stricture vary greatly in pathology, usually only one stricture, while gonococcal stricture may be multiple stricture. Stricture may be secondary to infection, forming urethral diverticula, perineal urethritis, prostatic or epididymal orchitis.

　　That's all about the introduction of 'What are the causes of urethral stricture?' today. Through the introduction, I believe you have some understanding. If you feel any discomfort in your body, please go to the hospital for a check-up in time. You can also consult our Feihua Health Network online experts to get answers from the experts.

　　Urethral stricture often can be complicated with recurrent bladder, perineal infection, upper urinary tract infection, and reproductive system infection. When complicated with acute orchitis and epididymitis, the scrotum becomes red and swollen, and painful; when complicated with acute prostatitis, perineal pain occurs, accompanied by systemic symptoms such as chills, high fever, and elevated white blood cells. Perineal cellulitis manifests as redness and tenderness in the perineal area, and after forming abscesses, they can spontaneously break through to form urethral fistulas. Urethral fistulas located distal to the external sphincter only have urine leakage during urination, while those located proximal have continuous urine leakage. Long-term difficulty in urination can be complicated with inguinal hernia, anal and rectal prolapse, and can also cause upper urinary tract hydronephrosis, eventually leading to chronic renal insufficiency.

　　The symptoms of urethral stricture can vary due to its degree, scope, and development process, with the main symptom being difficulty in urination.

　　At the beginning, urination is difficult, the time of urination is prolonged, and the urine is bifurcated. Gradually, the urine stream becomes finer, the range of射程 becomes shorter, and even presents as a dripping state. When the detrusor muscle contracts and cannot overcome the urethral resistance, residual urine increases, and even overflow incontinence or urinary retention may occur.

　　Narrowing of the urethra often accompanies chronic urethritis. At this time, the external orifice of the urethra often has a small amount of purulent discharge, which is usually found in the morning, with the urethral orifice sealed by 1 or 2 drops of secretion, known as 'morning drops'. The urethra proximal to the stricture is easily expanded, and it is prone to recurrent urinary tract infections, perineal abscesses, urethral fistulas, prostatitis, and epididymitis due to urine retention and concurrent infection.

　　Subsequently, due to obstruction, renal pelvis and ureteral hydronephrosis and recurrent urinary tract infections may occur, eventually leading to renal function impairment and even uremia.

　　Urethral stricture is usually seen in congenital abnormalities, infections, and iatrogenic injuries caused by urethral orifice stricture. Therefore, the prevention is mainly aimed at the above primary pathogenic factors. Congenital factors cannot be prevented, but early detection, early diagnosis, and treatment are of great significance for the indirect prevention of this disease. During pregnancy, regular examinations should be done, and if the child has a tendency of developmental abnormalities, chromosomal screening should be done in time, and if the result is clear, artificial abortion should be performed in time to avoid the birth of children with diseases.

　　Urethral stricture is a common disease of the urinary system, more common in males. Clinically, urethral stricture often manifests as congenital urethral stricture, such as congenital urethral orifice stricture, urethral valve, seminal calculus hypertrophy, congenital urethral lumen stricture, etc. After the diagnosis of urethral stricture, active treatment is needed, usually surgical treatment. Then, what examinations do patients with urethral stricture need to do? The following introduces the examinations for urethral stricture.

　　1, Urethral palpation and perineal scrotal examination

　　The stricture site along the urethra can be palpated, attention should be paid to its length, whether there is tenderness; whether there is secretion and its nature at the urethral orifice, whether the perineal skin has inflammation; the extensibility of the scrotum, whether there is a fistula and its direction.

　　2, Anal-rectal examination

　　It should be performed routinely, paying attention to the condition of the prostate and the posterior urethra. If there is a suprapubic cystostomy, the urethral probe can be inserted through the stoma into the neck of the bladder to the posterior urethra to assist in determining the position of the proximal end of the urethra.

　　3, Urethral probe examination

　　It can determine the site, degree, and length of the stricture. During the examination, the urethral probe is generally blocked at the stricture site, and the urethral probe is from large to small, which can measure the relative width of the stricture. If there is a suprapubic cystostomy, the urethral probe can be inserted through the stoma to the neck of the bladder and then into the posterior urethra to assist in determining the position of the proximal end of the urethral stricture, and the approximate length of the stricture can be measured.

　　4, Urethrogram examination

　　It can clearly and accurately show the site, degree, length, and various complications of the stricture, which can be divided into retrograde urethrogram and voiding urethrogram.

　　5, B-ultrasound examination

　　It can clearly identify the lumen of the urethra, the spongy tissue, and the surrounding layers of the urethra, so it can diagnose the length, degree, and thickness of the scar tissue around the urethral stricture, without the stimulation of iodine to the urethra and without the damage of radiation to the human body.

　　6, other examinations

　　such as endoscopic examination. If there is a suspicion of upper urinary tract lesions, venous uroradiography examination can be performed.

　　Feihua Health Network experts remind:Urethral stricture is more common in males, generally more serious, and requires surgical treatment.

　　Patients with urethral stricture should eat light and easily digestible foods, prefer foods rich in water, nutrition, and vitamins, eat more fresh vegetables and fruits such as green vegetables, watermelons, pears, fresh lotus root, loquat, etc., drink more water, drink soup, which can promote diuresis, eat more meals with a cooling and detoxifying, diuretic and urination-inducing effect: chrysanthemum brain soup, shepherd's purse soup, mallow head, winter melon soup, corn silk, white fungus, hawthorn, celery, lettuce, mung beans, red beans, etc.

　　Urethral stricture is a common disease in the urinary system, more common in males, and clinically common congenital urethral stricture such as congenital urethral orifice stricture, urethral valve, seminal colliculus hypertrophy, congenital urethral lumen stricture, inflammatory urethral stricture, often caused by urethral lumen infection and injury, and traumatic urethral stricture is often due to improper initial treatment.

　　Patients with urethral stricture who have failed non-surgical treatment can choose appropriate surgical treatment. There are many surgical treatment methods, and the choice depends on the doctor's experience, the patient's condition, and the medical conditions available. The following introduces five surgical treatment methods for urethral stricture.

　　1. Urethral Orifice Incision:

　　This method is suitable for cases with urethral orifice stricture. It is often seen in patients with balanoposthitis, partial penectomy after surgery, or after repair of hypospadias, where a longitudinal incision can be made on the ventral side of the urethral orifice to form a mild hypospadias, and the mucosa of the two sides of the urethra can be sutured with the skin of the glans penis to stop bleeding.

　　2. Urethral Incision:

　　This type of urethral stricture surgery is suitable for cases with very short urethral stricture, even membranous stricture, which can be incised under ureteroscopy using a special cold knife.

　　3. Urethral Stricture Resection and Reanastomosis:

　　For cases where internal incision is not possible, appropriate incisions should be made, and the narrowed segment of the urethra and surrounding scar tissue should be resected under good exposure, with strict hemostasis. The urethral ends should be sutured with absorbable sutures in an inverted manner without tension, which is a relatively difficult method in the treatment of urethral stricture.

　　4. Urethroplasty:

　　Defective urethra can be repaired using autologous bladder mucosa, pedicled bladder flap, or thick skin grafts.

　　5. Urethral Diversion Surgery:

　　Generally, urethral stricture surgery requires simultaneous cystostomy to drain urine, so that the surgery can be successful. Patients with failed surgery can maintain a cystostomy to wait for a second surgery or as a permanent treatment.

　　Expert reminder from Feihua Health Network:Patients with urethral stricture must choose a regular hospital for treatment. At the same time, patients should closely cooperate with doctors and strictly follow medical advice to achieve good therapeutic effects. Wishing all patients a speedy recovery.