Urethral Stenosis
Introduction
Urethral stricture is an abnormal narrowing of the urinary tract that prevents urine from flowing normally. It can cause embarrassing urinary problems, pain and, in severe cases, more serious complications such as urinary tract infections or acute urinary retention.
⚠️ If left untreated, urethral stenosis can lead to serious complications, such as kidney failure.
💡 Good news: there are treatments! Early treatment can restore normal urinary flow and avoid complications.
What is urethral stricture?
The urethra is the channel through which urine flows from the bladder to the outside. When the urethra narrows, urine has difficulty passing, leading to a variety of symptoms.
📌 A few figures:
✅ Urethral stenosis affects 1 in 1,000 men, especially after the age of 50.
✅ It is rare in women, as their urethra is shorter and less exposed to trauma.
✅ If left untreated, urethral stenosis can progress to the point where the evacuation of urine is completely blocked.
What are the symptoms of urethral stricture?
Urethral stenosis may be asymptomatic at first, but gradually progresses to disabling urinary disorders.
- Weak or jerky urine stream
- Frequent urination and urinary urgency
- Pain or burning sensation when urinating
- Residual discharge after micturition ("delayed drops")
- Frequent urinary tract infections
- Acute urinary retention (total blockage of urine)
📌 The tighter the stenosis, the more severe the symptoms.
What causes urethral stenosis?
Urethral stricture can occur after injury or infection, but some causes remain unknown.
1️⃣ Trauma and injuries
- Repeated urinary catheterization.
- Surgery on the prostate or bladder.
- Falls or blows to the perineum.
- Participation in high-risk sports (cycling, horse-riding, etc.).
2️⃣ Infections and Inflammations
- STIs (gonorrhea, chlamydia).
- Chronic prostatitis or urethritis.
- Lichen sclerosus (skin disease leading to fibrosis).
3️⃣ Congenital or unknown causes
- Some stenoses are present from birth.
- In some cases, no precise cause is identified.
📌 An assessment by a specialist is essential to identify the cause and choose the right treatment.
Impact on quality of life
Urethral stenosis considerably impairs daily life:
- Permanent discomfort and pain when urinating.
- Fear of not being able to urinate normally (anxiety and stress).
- Disturbed sexual relations (erectile difficulties, pain).
- Increased risk of urinary tract infections and renal failure.
💡 Appropriate treatment can help restore urinary comfort and improve quality of life.
What solutions exist?
1️⃣ Drug treatments (mild cases)
Drug treatments cannot cure stenosis, but they can relieve certain symptoms:
- Antibiotics in case of associated infection.
- Anti-inflammatories to reduce irritation.
- Alpha-blockers to improve urinary flow.
📌 These treatments are often a temporary solution before surgery.
2️⃣ Urethral dilatation
- Introduction of a balloon or instrument to widen the urethra.
- Minimally invasive but often temporary (high risk of recurrence).
📌 Indicated for short, mild stenoses.
3️⃣ Endoscopic urethrotomy
- Endoscopic surgery to incise the stenosis and restore urine flow.
- Minimally invasive, rapid recovery, but possible recurrence.
📌 Indicated if the stenosis is short and not very fibrous.
4️⃣ Reconstructive surgery (Uretroplasty)
- Grafting or reconstruction of the urethra to permanently widen the canal.
- More invasive technique, but effective over the long term.
📌 Indicated for long or recurrent stenoses.
5️⃣ Urethral Stenting
- Placement of a stent to keep the urethra open.
- Indicated for patients for whom surgery is too risky.
📌 Last-resort solution for major recurrences.
Why consult a specialist?
A urologist can :
- Confirm the diagnosis with urethrography or endoscopy.
- Evaluate the severity of stenosis and suggest appropriate treatment.
- Avoid serious complications (renal failure, severe infections).
📌 Don’t let urethral stricture develop. The earlier it is treated, the simpler and more effective the treatment.
Do you suffer from urinary problems?
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