Urethral slit and urethral reconstruction for urethral stricture

Injuries to the urethra often result in the development of a stricture due to scarring. As a result, urination becomes difficult, the urinary stream is weakened, and bladder emptying may be incomplete. The usual treatment for urethral stricture is endoscopic slitting of the scar causing the stricture. Unfortunately, the urethra tends to form new strictures (recurrence). In certain cases, repeated slitting does not offer a definitive solution to the problem. Various open surgical procedures are available to reconstruct the urethra in case of recurrence. Oral mucoplasty, for example, can be used to successfully treat the narrowing. This procedure should be performed by an experienced urological surgeon.

Questions about the diagnosis and treatment of urethral stricture

The urethra carries urine from the bladder to expel it from the body. Injuries to the urethral mucosa can lead to scars that narrow the urethra and impair urination. Symptoms can range from a weakened urinary stream to disturbances in bladder emptying to acute urinary obstruction.

Administering a contrast medium into the urethra as part of an X-ray examination allows the doctor to see the location, extent, and length of the stricture. Urethral and bladder endoscopy can detect the stricture using visual inspection. Ultrasound as the sole examination method is not suitable for diagnosing the stricture with sufficient precision.

Injuries to the urethra, for example after a fall off of a bicycle or a kick in the groin, can cause narrowing, even years later. In addition, temporary or permanent urinary diversion through a catheter or surgery through the urethra can cause urethral stricture. It is not uncommon for sexually transmitted diseases involving the urethra, such as gonorrhoea, to result in a urethral stricture.

The first step in treatment usually consists of endoscopic slitting of the scar. However, it is important to keep in mind the tendency of recurrence, i.e. a renewed formation of the constriction. In case of recurrence, repeated slitting is not a permanent solution. Different open surgical procedures for reconstructing the urethra are available in case of recurrence. For example, the constriction can be successfully treated by means of oral mucoplasty.

Treatment