Urethral stricture is called the restriction ( in some cases it may be a complete imperforate ) lumen of the urethra. From this definition, it becomes clear that urethral stricture prevents the normal emptying of the bladder. What is the consequence this state ?
Gradually increases in the bladder residual urine that eventually causes desensitization of the bladder and is reflected in its contractile ability . Because of this, there are problems with the kidneys, which can not function effectively and eventually develop kidney failure. Not cured stricture may also lead to the development of the following problems:
urinary retention, urinary stones ;
hydronephrosis ( deformation of the structure of the kidneys) ;
urethrodiverticulum (extension wall of the urethra) ;
urethral fistula ( in the wall of the urethra appears a hole through which the outflow of urine) ;
infection of the urethra ;
also against the background of the disease in men may develop secondary prostatitis .
Therefore experiencing discomfort during urination , in any case should not run situation , an urgent need to see a doctor – urologist with this “delicate” issue.
That should alert
The main signs of incipient disease : the weakening of the stream of urine , painful urination and a reduction in urine output , a feeling of incomplete emptying of the bladder , spraying jets of urine during urination , long ” attitude ” to urinate. Also should alert abdominal pain, blood in the urine and discharge from the urethra .
Hurry to the person skilled in the need , if there are two or more of the features described herein .
What Causes It
Most often urethral stricture may result from injury. It can be such injuries :
trauma or injury perineum, penile injury hanging urethra ;
pelvic trauma with fracture of the pelvis ;
stricture formation after medical procedures ( surgery on the penis and urethra, prostate surgery , etc.);
In some cases, the stricture may result from inflammation of the urethra . Among the main reasons : an infectious inflammation of the urethra (tuberculosis , gonorrhea) , chemical damage to the urethra , nonspecific degenerative- dystrophic processes .
There are several basic methods for determining the diseases that help professionals make the correct diagnosis . In addition to mandatory laboratory tests the patient will be assigned special studies : uroflowmetry , uretrotsistosokpiya , urethrography , imaging and urodynamics .
More recently, for the treatment of urethral strictures applied the so-called probing . However, the method does not provide 100 % of the effect ( the recurrence remained high ) causing constantly conducted the search for new treatments for the disease.
The next step was the treatment of urethral strictures endoscopic surgery , the so-called internal optical urethrotomy . This method is referred to specialists ” sparing ” , but here relapses were observed in approximately 80 % of all cases.
The next stage – the operation called ” urethroplasty .” There are several methods , but the essence of the operation is reduced to the excision of the narrowed area of the urethra with subsequent re- resected ends.
However, at the moment, experts practice two methods which have proved equally effective . First – the transplantation of cheek mucosa of the patient in place dissection stricture . This method is effective , firstly, avoiding the recurrence ( re- narrowing occurs in about 10% ) , and, secondly , there is no warp bodies. There is another advantage of the operational method – restoration of the independent urination occurs in 2-3 weeks . About cheeks too should not worry – the buccal mucosa recovered pretty quickly.
Another method practiced at the moment and is the most progressive – transplantation of artificial materials and tissues obtained by tissue engineering. It’s about growing a sick person ‘s own cells that occurs in the laboratory on special matrices. Grown so used to replace tissue scar- modified and non-viable tissue organs.
Along with the aforementioned progressive methods practiced in some clinics use biorezorbtivnyh stents. The operation consists in that the stent ( necessary tube length) is set to the desired portion ( a restriction site ) . After a while the stent dissolves , but during this time the urethra is formed around the stent and acquires the necessary clearance .
Thus, the treatment of urethral stricture modern science and practice has accumulated quite a lot, and that it will require a particular patient , the attending physician is already doing