Urethral Stricture
Definition and Types
Urethral stricture refers to the narrowing of the urethra due to injury, infection, or other causes. There are two main types of urethral strictures: membranous and bulbar.
- Membranous urethral stricture: This type occurs in the membranous part of the urethra, which is the shortest and narrowest part of the urethra.
- Bulbar urethral stricture: This type occurs in the bulbar part of the urethra, which is the widest part of the urethra.
Causes of Urethral Stricture
- Trauma: The most common cause of urethral stricture is trauma, which can be caused by a fall, a car accident, or a sports injury.
- Infection: Infections such as gonorrhea or chlamydia can cause urethral stricture.
- Iatrogenic: Urethral stricture can also be caused by medical procedures such as catheterization or surgery.
Pathophysiology of Urethral Stricture
- Inflammation: The initial stage of urethral stricture is characterized by inflammation of the urethral mucosa.
- Fibrosis: As the inflammation progresses, fibrosis occurs, leading to the narrowing of the urethra.
- Scarring: The narrowing of the urethra can cause scarring, which can lead to further narrowing and eventually to complete urethral obstruction.
Clinical Features of Urethral Stricture
- Dysuria: Patients with urethral stricture often experience dysuria, which is painful urination.
- Hematuria: Some patients may experience hematuria, which is blood in the urine.
- Urinary retention: Urethral stricture can cause urinary retention, which is the inability to urinate.
- Nocturia: Patients with urethral stricture may experience nocturia, which is frequent urination at night.
Diagnostic Tests for Urethral Stricture
- Urinalysis: Urinalysis can help diagnose urethral stricture by detecting signs of infection or inflammation.
- Urinary flowmetry: Urinary flowmetry can help diagnose urethral stricture by measuring the flow rate of urine.
- Urethroscopy: Urethroscopy is a procedure that involves passing a small scope through the urethra to visualize the inside of the urethra.
- Cystoscopy: Cystoscopy is a procedure that involves passing a small scope through the urethra and bladder to visualize the inside of the bladder.
Role of Urethroscopy and Cystoscopy
- Visualization: Urethroscopy and cystoscopy can help visualize the inside of the urethra and bladder.
- Biopsy: Urethroscopy and cystoscopy can also help take biopsies of the urethral mucosa and bladder wall.
- Stent placement: Urethroscopy and cystoscopy can also help place stents in the urethra to help improve urine flow.
Retrograde Urethrography Findings
- Urethral narrowing: Retrograde urethrography can help visualize the narrowing of the urethra.
- Urethral stricture: Retrograde urethrography can also help diagnose urethral stricture by showing the narrowing of the urethra.
Role of Uroflowmetry
- Urine flow rate: Uroflowmetry can help measure the flow rate of urine.
- Urethral obstruction: Uroflowmetry can also help diagnose urethral obstruction by measuring the flow rate of urine.
Role of CT Scan and MRI
- Imaging: CT scans and MRI can help visualize the urethra and bladder.
- Diagnosis: CT scans and MRI can also help diagnose urethral stricture by showing the narrowing of the urethra.
Management of Urethral Stricture
- Self-dilation: Self-dilation involves using a dilator to slowly stretch the urethra.
- External urethral dilation: External urethral dilation involves using a dilator to slowly stretch the urethra.
- Internal urethral stenting: Internal urethral stenting involves placing a stent in the urethra to help improve urine flow.
- Surgery: Surgery may be necessary to repair the urethra.
Homoeopathic Therapeutics for Urethral Stricture
- Calcarea carbonica: Calcarea carbonica can help treat urethral stricture by reducing inflammation and promoting healing.
- Graphites: Graphites can help treat urethral stricture by reducing inflammation and promoting healing.
- Lycopodium clavatum: Lycopodium clavatum can help treat urethral stricture by reducing inflammation and promoting healing.
- Natrum muriaticum: Natrum muriaticum can help treat urethral stricture by reducing inflammation and promoting healing.