Urethral Stenosis In Men: Manifestation And Management

Stenosis of the urethra is a common urological disease, manifested by an infection or a trauma of the urinary system. Need to understand the etiology of the disease to have timely management to avoid complications.
Male urethral structure
The urethra is divided into 2 parts: the anterior and the posterior urethra. The anterior urethra is 12-15 cm long, surrounded by a porous object, consisting of a fixed part, also known as the urethra and the mobile part called the urethra penis. The posterior urethra is 4.5 - 5cm in length, including the urethral membrane that passes through the perineum and prostate urethra. The average diameter of the urethra is 4 - 6mm, when dilated by 8 - 10 mm, the urethra is not a regular round tube but has narrow and wide spaces.
Urethral stenosis how?
Stenosis of the urethra is usually the result of a urethritis infection, originating from the foci in littre glands caused by gonococcal bacteria that shelter and cause disease, and long-term scarring that narrows the urethra in many places; due to a foreskin infection, intercourse usually occurs, narrows down and can spread to the prostate and urethra; caused by systemic lesions of renal tuberculosis, bladder tuberculosis and spread to urethral tuberculosis Stenosis of the urethra also caused by sequelae of urethra trauma; after the procedure of taking urethral stones to damage the lining of the urethra, after surgery to remove prostate enlargement


Stenosis of the urethra is often the result of inflammation of the urethra
Manifestations of narrowing of the urethra
After treatment of infection or trauma, patients complain of difficulty urinating, when urine blinks weakly, twists and drips.


Urethral Stenosis In Men: Manifestation And Management

The time to urinate is longer than 30 seconds to 1 minute, you still want to urinate, stimulate straining during urination.
In case of true urinary retention, when accompanied by superinfection or trapped stones, the urethra is completely narrowed, making the patient very uncomfortable, bladder distention, and need to urinate immediately.
Examination of the urethra, finding lesions such as foreskin narrowing, detecting segments, urethral sclerosis when manipulating the urethra from the head to the penis base. When the ureter catheter is placed with the Nelaton 18 sonde, it will not pass through the urethra.
Progress and complications
After urethral stenosis, the patient still suffers, trying to urinate in a natural way for a while, depending on the extent of damage, progressing to a full narrowing. Suffering, trying to naturally urinate gradually leads to complications. Stagnation of bladder urine causes upstream infections to the ureters and kidneys
Due to long-term stagnation, there is no way out, causing skin leakage at the perineal area or scrotum and stagnant area with infection forming honeycomb abscess, causing formation of excess bladder and long-term Complications of renal failure.


Urethral Stenosis In Men: Manifestation And Management


Stenosis of the urethra can complicate into bladder abscess, kidney failure
Distinguish other diseases
Bladder neck stenosis due to cystitis cystitis: seen in cases after surgery for prostate fibroids. Patients with symptoms of difficulty urinating, when the catheter is placed, the catheter stops in front of the bladder neck, urethra scan with contrast, on X-ray images do not see contrast material to get into the bladder.
- Prostate fibroids: patients with difficulty urinating, urinating, interrupting urine flow, urinary stream abruptly decreases, when the rectal examination touches the tumor. This disease is often seen in the elderly.
Management of urethral stenosis
Depending on the degree of damage, the location of the disease that we have different management. In the case of an urethral stenosis with an progressive progression to abscesses, urine leakage and acute urinary retention, the bladder must be opened to drain the skin, treat all infections with antibiotics or high-dose antibiotics , whole body like augmentin, ceftriaxon, tobramycin. Cases of tuberculosis require specific treatment.
Mild urethral stenosis can be treated with high doses of antibiotics
Etiology: urethral dilatation, which is still applied to dilating the urethra and placing a small catheter sonde that is used to guide the path through the narrow space and then expand.


Urethral Stenosis In Men: Manifestation And Management

Currently, there are many methods of catheterization with sonde with balloon inserting in place of the urethra.
Surgical treatment of urethral stenosis to regenerate the urethra. Over the years, the surgical methods have been constantly improved, helping the ability of the urethra to return to the original physiology, in order to improve the quality of life for patients..

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