Urethral strictures may seem harmless, but not getting the proper treatment can seriously affect your health. Given urinary disorders are common among the ageing population, urethral strictures or infections resulting from them can take a long time to heal and recover. Plus, with age, men especially become more susceptible to conditions like an enlarged prostate, which can be a direct risk factor for urethral strictures. So, how do you keep yourself safe? 

The only way to be safe is to take note of the symptoms, go through a proper diagnosis, and then create a dedicated urethral stricture treatment plan with your doctors. There are various treatment options for urethral strictures, including urethral stricture treatment without surgery and urethral stricture laser surgery treatment options. But before you learn about the treatments, let’s learn about the acute symptoms of urethral strictures.

Urethral Stricture Symptoms

Urethral strictures symptoms affect your ability to empty your bladder properly. Like many urinary conditions, the symptoms of urethral stricture can feel similar to other conditions, and the only way to differentiate between the symptoms is to get a proper medical diagnosis. If you are showing any of the following symptoms, you should see a doctor.

Early Symptoms

These symptoms can slowly sneak up on you, and being aware and mindful will help you get an early diagnosis for your condition, which helps make the treatment a lot easier. Here are some of the early symptoms that you might be noticing.

• Increased frequency of urination
• Increased urgency of urination

Both these symptoms can be easy to miss, but if you notice that you need to urinate more than 4-5 times a day, it can indicate trouble within your urinary system. However, with these symptoms, it is important to note that age is also a crucial factor. Increased frequency of urination at ages over 40 or 50 would indicate urethral strictures. If you are younger than that, the probability of your increased frequency or urgency of urination will not, in most cases, immediately mean urethral strictures. If you urinate more than 8 times a day or can’t seem to hold your urine when you want, it can be telltale symptoms of something being wrong with your urinary tract. What are other telltale symptoms of urethral strictures? Let’s find out.

Telltale Symptoms

A quick disclaimer, the symptoms of urethral strictures are very difficult to diagnose from the get-go before getting a proper diagnosis. This is mainly because the symptoms of urethral strictures match closely with another condition known as benign prostatic hyperplasia or BPH. 

BPH is a prevalent condition that can affects more people than urethral strictures. So, even with these telltale symptoms, you can get an assessment that something is wrong with your urinary system, but you won’t be able to diagnose the condition outright at home. You will need medical help for the diagnosis. Here are some of the most common symptoms of urethral strictures.

• Swelling in your pubic region
• Pain while urinating
• Difficulty emptying your bladder when urinating
• Infections in your urinary tract
• Unsteady flow of urine

Some of these symptoms, like swelling in your public region and urinary tract infections, point towards urethral strictures more than other conditions. And with the help of medical diagnosis, you can confirm if that is the case. So, how are urethral strictures diagnosed? Let’s find out.

Urethral Stricture Diagnosis

Urethral stricture diagnosis follows a few steps. Given the symptoms can be misleading in some ways, doctors have to complete a few tests to confirm that you have a urethral stricture. So, how does the diagnosis process go? Here are the steps.

• Doctors will take account of your medical history, including any conditions you have, your age, and your lifestyle.
• Based on that information, doctors will ask you about your symptoms and ask you questions regarding your condition.
• Doctors may even conduct physical examinations to check if you have any injuries or deformities. If you have an injury, it can be the primary cause of your symptoms. 

If your injury is not clearly visible or if you don’t have injuries, doctors will suggest you go for some diagnostic tests to confirm their diagnosis. However, before that, doctors will often do some general tests to rule out other possibilities like BPH, and a prostate exam does that. If your prostate is of a healthy size, it can help rule out BPH. Now there are two ways to diagnose urethral strictures. Invasive diagnosis and non-invasive diagnosis.

With a non-invasive diagnosis, doctors can confirm if you have a stricture or not. However, the location of the stricture can’t be understood without invasive diagnostic tests. Let’s take a look at both invasive and non-invasive diagnostic processes used for urethral stricture.

Non-Invasive Test

• Urine Flow Test: This is a non-invasive diagnostic test where doctors test the speed and strength of your urine flow. The strength of your flow can help doctors understand if you have a stricture in your urethra or not.
   
• Ultrasound: Once you have completed the urine flow test, doctors will generally ask you to go through an ultrasound test to check for the residue urine in your body. This will help doctors understand the severity of the stricture.

Invasive Test

• Urethroscopy: Urethroscopy, also known as cystoscopy, uses a small narrow tube with a camera and light at one end, which is inserted into your urethra. The device is pushed inside your urethra to find the stricture and understand its size and nature. Doctors use a medicated gel to lower the discomfort, and even though it is an invasive procedure, it only takes 5-10 minutes to complete.
   
• X-Ray: Sometimes doctors can also use an X-ray with a contrast liquid to check for urethral strictures. The procedure involves squirting the contrast liquid into your urethra and then checking it under a fluoroscopic X-ray. The process is called retrograde urethrogram, and it helps doctors see the stricture and its length using a non-invasive process.

These are the most common diagnostic tests used to diagnose urethral strictures. Based on your case's severity, risk factors, and medical history, doctors devise a treatment plan for you that will help you recover quickly. One of the biggest concerns with urethral strictures is that they can reoccur, so doctors make considerable efforts to ensure the treatment plan devised for you allows you to treat the condition properly.

Urethral Stricture Treatment

Urethral stricture treatment options are only limited to surgical processes. This is a condition that can not be treated with medicines. If you ignore your symptoms for too long or try to live with them, it will start affecting the other parts of your urinary system, including your kidneys. Thanks to modern technology, there are several minimally invasive surgical treatment options for urethral strictures. Here are the most commonly prescribed procedures for this condition.

Dilation

dilation is a common procedure prescribed to patients with urethral strictures. They are safe and they can be completed without the patient needing a hospital stay. dilation is also a safe procedure and it is minimally invasive, with no need to make incisions in your body. A tube with the surgical apparatus is inserted into your urethra and that is used to clear the stricture. There are several ways to perform dilation, here are the different ways.

• Balloon dilation: A balloon is inserted into the urethra and once it reaches the stricture, it is blown up to widen the urethra and clear the stricture.
• Visual Internal Urethrotomy (VIU): This procedure involves putting a wire guided dilator into the urethra, which is used to dialate the urethra and remove the stricture.
• Optical Internal Urethrotomy (OIU): OIU uses the same basic principles of inserting the surgical tools inside the body through the urethra, but in this case, a laser is used to melt the stricture away.

VIU and OIU processes are performed under general anaesthesia. The patients can still be discharged on the same day of the procedure if they recover well. In case of balloon dilation, doctors use local anaesthesia and patients may need to stay the night at the hospital, based on their recovery.

dilation is an effective treatment process for urethral strictures, but one of the major disadvantages of dilation is that it can’t definitely cure urethral strictures at once. Often, patients require multiple dilations to get rid of their strictures. Plus, in case of complex strictures, this procedure can’t stop the strictures from coming back. So, doctors often prescribe other procedures after or instead of dilation in such cases to stop the recurrence of strictures.

Urethral Stent

Stents are small tube-like structures made from bio-compatible materials. They are placed inside your urethra to keep it open and stop it from contracting further. Stents can be placed in other parts of your body too, most commonly the heart. Urethral stents are inserted into your body through the urethra under local anaesthesia and kept there for a set period. The time of how long the stent is kept inside your body is dependent on your case.

This procedure is done on an outpatient basis and doesn’t generally require you to stay a night at the hospital. The procedure is also very safe and effective in ensuring the stricture is treated. However, upon the removal of the stent from your urethra, the strictures can return. The stent can help you relieve your symptoms, but only your doctors can decide if it is right for you or not.

If your doctor does decide to prescribe the procedure to you, you should know that stents can cause some discomfort and pain while urinating for a while after the surgery. And given the stent is kept inside your body, you have to follow the post-surgical care routine very closely to ensure you don’t get any complications.

Urethrotomysis

Urethrotomysis is a minimally invasive procedure that creates an incision in the stricture to widen it. This procedure is performed under general anaesthesia and patients can go home the same day after the procedure. There are two ways to perform this procedure.

• Internal Urethrotomy (IUU): This process uses a urethroscope that is inserted into your urethra and the stricture is cut open using a scalpel or with a laser. This procedure does not require any incisions to be made in your body.
• External Urethrotomy (EUU): Based on the location of your stricture, an incision is made on the skin of your perinium and the stricture is accessed from the outside and incised.

This procedure is effective in helping you treat your condition and get rid of the symptoms. However, recurrence of the strictures can be a common problem with urethrotomysis. Based on your case severity doctors might have to perform this procedure multiple times to treat your condition. You can also be prescribed other procedures after getting your urethrotomysis.

The recovery time for this procedure is quick, but you will feel some side effects like pain during urination for a while. Taking the post-operative care tips seriously is crucial for your safety after this procedure. Your urologist will ask you to come in regularly after your procedure to check if you are recovering properly and they might even prescribe other procedures based on your progress.

Endoscopic Onlay Graft

Endoscopic Onlay grafts are one of the most complex treatment processes for urethral strictures. This minimally invasive surgery is performed under general anaesthesia and may require you to stay at the hospital overnight for a full recovery. The procedure involves inserting a camera fitted endoscope in your urethra. Then a tissue is grafted from another part of your body namely oral tissue or mucosal tissue and it is placed over your stricture. 

This procedure helps widen the stricture and it is one of the only procedures that offer a permanent treatment for urethral strictures. Meaning, getting this surgery ensures that your strictures will not reoccur.

The recovery period for this procedure is short, but you can have some common side effects like pain during urination for a few days after the procedure. You also need to take special care of your health while recovering to ensure there are no post-operative complications. You have to maintain follow up visits with your doctor after the surgery to keep track of your recovery, and that will help you recover quickly, safely, and certainly from urethral strictures once and for all.

Conclusion

With this expansive look into the symptoms, diagnostic processes, and treatment options for urethral strictures, you now have all the information needed to get your condition treated. Urethral strictures can be a common occurrence for people over certain ages, but living with it is not good for your health. 

Visit MASSH today and we will help you definitely treat your urethral strictures. Our experienced doctors and world-class infrastructure allows us to offer the best minimally invasive treatment options for urethral strictures. So, if you have any of the symptoms discussed in this article, check out our website and book an appointment today to speak to our experts.