URETHRAL STRICTURES

BY PATTI HAMILTON

What is a urethral stricture?

A urethral stricture is a narrowing in any part of the urethra – the tube that drains urine from the bladder. This impairs normal urine flow.

Etiology Urethral injury, disease,

catheterization or surgery that results in inflammation or scar tissue.

Urethral infections, such as gonorrhea. A tumor in the urethra (rarely) A complication of radiation treatment

of the pelvis May be congenital or acquired.

Risk factors Increased risk is associated with men

who have a history of sexually transmitted disease, repeated episodes of urethritis, and benign prostatic hyperplasia. There is also increased risk of stricture after an injury or trauma to the pelvic region. Any instrumentation entering the urethra increases the chance of developing urethral strictures.

Signs and symptoms Dysuria. Hematuria. Weak stream. Splaying of the urine stream. Nocturia. Incomplete emptying. Pain with bladder distention. Urinary tract infection (fever and

malaise may be present with a urinary tract infection.

Diagnostics

Voiding cystourethrography (pictured)

Cystoscopy

Medical management Surgery to correctThe condition – openUrethroplasty.

Medical management cont’d

Suprapubic catheter – inserted temporarily to drain the bladder.

Internal incision of the stricture via a cystoscope or endoscope.

Permanent catheter. Dilating the stricture by inserting a

stent.

Nursing interventions Adequate hydration – to decrease

discomfort when voiding Monitor urine output. Mild analgesics. Sitz baths – to encourage voiding. If urethroplasty is performed – splint the

catheter to support the catheter line. Do not cause tension on the catheter.

Prognosis

Without appropriate treatment, the stricture will almost always recur. But, after surgical correction or dilation the prognosis is favorable.