Urethral Stricture

T

he Urinary system is constituted by the kidneys, ureters and the urethra. The urethra is a tube structure through which the urine expels abroad.

Urethral stricture is a condition which basically consists of a narrowing of the urethra.

This can be caused by injury, instrumentation, infection, and certain non-infectious forms of urethritis.

Currently, it is considered that urethral strictures develop secondarily to a process of scarring or fibrosis of the urethral mucosa and/or periurethral tissues, so any process that conditions a trauma can propitiate a urethral stricture.

So, here´s a brief explanation of 3 treatment options:

• Urethral dilatations:
  The first treatment described for this pathology is periodic urethral dilation, which is recommended in stenoses smaller than 2 cm. A complication rate or failure rate has been reported with this treatment in 32% of patients. Some authors consider it as a non-curative therapy, so it has been replaced by balloon dilatations, stents, and direct visual internal urethrotomy (DVIU).
  
  
• Internal urethrotomy:
  It has become the most used technique compared to urethroplasty, since it is considered a simple, safe procedure, with a short and simple convalescence time to perform despite having a risk of recurrence during the first 6 months of a 50%. The objective of this technique is to allow reepithelialization before the scar is faced again, with which the urethral scar would be remodeled to an open position.
  
  
• Urethroplasty:
  The technique consists of opening the urethra at the level of the penis or perineum, with excision of the segment that presents the stenosis. Depending on the location and length of the stenosis, the reconstruction can be performed in a single time or it may be necessary to leave the urethra open to facilitate its regeneration, proceeding to the final reconstruction in a second time.