Narrowing of the urinary opening results in a deviated or spread-out urinary stream.Frequent and painful urination are also common initial complaints. Symptoms include weak urinary stream, straining to urinate, a spread-out stream, hesitancy, incomplete emptying, urinary retention and post-urination dribbling. As the urethral lumen (cavity) gradually narrows, obstructive voiding symptoms worsen, and this becomes an insidious pattern.Potentially, extensive urethral stricture disease can occur in this manner. LSA starts as inflammation of the glans that can result in severe narrowing of the urethral opening, high pressure voiding and eventual inflammation of the (Littre) glands in the tissue surrounding the urethra. It is a common cause of phimosis (infection of the foreskin), and thus often occurs temporarily after circumcision. In Western countries today, the most common cause of inflammatory strictures is lichen sclerosus et atrophicus (LSA), where whitish plaques commonly affect the glans (the head of the penis), meatus (urinary opening) and foreskin. In impoverished countries, more than 90 percent of strictures are inflammatory. Inflammatory strictures, such as those secondary to gonococcal or chlamydial urethritis (inflammation of the urethra caused by gonococcal or chlamydial bacteria), are relatively uncommon today.Most present day urethral strictures are the result of blunt trauma to the perineum (the area between the thighs from the end of the spinal column to the pubic bone), such as straddle injury, or instrumentation, such as traumatic catheter placement or removal or a chronic indwelling Foley catheter.The anatomic location of the lumen (urethral cavity) in relation to the spongiosum is critical for selecting the sites for internal surgical incision in the urethra. The relative location of the urethra within the spongiosum changes along the divisions of the urethra. Strictures usually do not cause symptoms until the urethra tube is below a certain size. The scar (stricture) is composed of dense collagen and fibroblasts (proteins that form cell-producing connective tissue) and thus contracts in all directions, shortening urethral length and narrowing the diameter of the urethra. The posterior urethra is the part of the urethra that travels through the prostate and the external sphincter valve.Īn anterior urethral stricture is a scar of the urethral epithelium (the urethra’s outside layer of cells) and commonly extends into the underlying corpus spongiosum (a column of erectile tissue that surrounds the urethra). The anterior urethra is the portion of the urethra from the tip of the penis to just before the prostate. The urethra in males is the tube that carries urine from the bladder to the outside of the body and also serves as the channel though which semen is ejaculated. Informed Consent for Telehealth Consultation.Communicate securely with your physician’s office.Urologic Trauma and Reconstruction Fellowship.2014 Summer Student Research Experiences.2013 Summer Student Research Experiences.Planning Center for Research in Benign Urology Planning Center for Research in Benign Urology.Laparoscopic Retroperitoneal Lymph Node Dissection (RPLND).Advanced Optical Imaging Cancer Detection.Surgery for Prostate Cancer: Laparoscopic.Ureteropelvic Junction (UPJ) Obstruction in Children.Urethral Stricture Disease Urethral Stricture Disease.Reconstructive Urology Reconstructive Urology.
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