Materiały źródłowe

• #1 Urethral Stricture: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/urethral-stricture

  A urethral stricture is a narrowing of your urethra. […] Contact a healthcare provider if you have a slow or weak pee stream. […] Noninvasive tests cant determine if a urethral stricture or another condition is affecting your ability to drain your bladder. If a provider suspects a stricture, they may order a retrograde urethrogram to identify and measure it. […] The provider may also perform a cystoscopy. During a cystoscopy, theyll insert a small, flexible scope with a camera at the end into your urethra. The cystoscope allows the provider to identify and locate a stricture. […] Urethral stricture treatment may include: Urethral dilation. During this procedure, a urologist uses long, thin rods that gradually increase in thickness to open the stricture. […] A urologist will remove the stricture and reconnect the healthy ends of your urethra.

• #1 Urethral stricture – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/urethral-stricture/diagnosis-treatment/drc-20556091

  To make a diagnosis, a member of your health care team will ask about your symptoms and your medical history and do an exam. Tests that can help find where the stricture is, how long it is and what’s causing it might include: […] Urine tests. These look for infection, blood or cancer in the urine. […] Urinary flow test. This measures the urine flow and how strong it is. […] Urethral ultrasound. This shows how long the stricture is. […] Pelvic ultrasound. This looks at whether there’s still urine in the bladder after emptying it. […] Pelvic MRI scan. This looks at the pelvic bone to see how it’s involved with the condition. […] Retrograde urethrogram. This test uses X-ray images to look for a problem or injury of the urethra. It also shows how long the stricture is and where it is. […] Cystoscopy. This uses a thin, tubelike tool that has a lens, called a cystoscope. The tool looks inside the urethra and bladder.

• #1 EAU Guidelines on Urethral Strictures – Uroweb

  https://uroweb.org/guidelines/urethral-strictures/chapter/diagnostic-evaluation

  A comprehensive diagnostic evaluation of urethral stricture disease encompasses clinical history and examination, urinalysis (+/- culture), uroflowmetry and post-void residual (PVR) assessment, radiography, and endoscopy. […] The clinical presentation of urethral stricture disease is varied. In a retrospective analysis of 611 patients with an endoscopically confirmed diagnosis of urethral stricture, LUTS were the most common presentation (54.3%) followed by acute urinary retention (22.3%), urinary tract infection (UTI) (6.1%) and difficult catheterisation (4.8%). […] To establish aetiology, an enquiry about a history of pelvic, genital, or perineal trauma, prior instrumentation, prior surgeries, irradiation or focal therapies and urethritis should be made. […] The performance status of the patient should be determined as it may influence the choice of treatment (curative or palliative).

• #1 Urethral stricture: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001271.htm

  Urethral stricture is an abnormal narrowing of the urethra. The urethra is the tube that carries urine out of the body from the bladder. […] A physical exam may show the following: Decreased urinary stream, Discharge from the urethra, Enlarged bladder, Enlarged or tender lymph nodes in the groin, Enlarged or tender prostate, Hardness on the under surface of the penis, Redness or swelling of the penis. […] Tests include the following: Cystoscopy, Postvoid residual (PVR) volume (usually by ultrasound), Retrograde urethrogram, Tests for chlamydia and gonorrhea, Urinalysis, Urinary flow rate, Urine culture. […] The urethra may be widened (dilated) during cystoscopy. […] If urethral dilation cannot correct the condition, you may need surgery. […] A surgery called an open urethroplasty may be done for longer strictures. […] The outcome is often excellent with treatment. […] Contact your health care provider if you have symptoms of urethral stricture. […] Treating a urethral stricture quickly may prevent kidney or bladder complications.

• #1 Urethral Stricture | Urology | UPMC

  https://www.upmc.com/services/urology/conditions/urethral-stricture

  A urethral stricture happens when scar tissue builds up in the urethra. […] Doctors can treat urethral stricture with surgery. […] Urethral stricture is almost always an adult male problem. […] If left untreated, a urethral stricture can lead to chronic UTIs. […] You should see a doctor if you have any of these symptoms of urethral stricture: A weak or slow urine stream. […] Your doctor will ask you about your symptoms and health history. […] They’ll give you a physical and may run tests such as: An ultrasound or x-rays of the urethra. […] A urethral stricture is highly treatable. […] The UPMC Department of Urology has a team of urologic surgeons with expert training. […] We most often treat urethral stricture with surgery.

• #1 EAU Guidelines on Urethral Strictures – Uroweb

  https://uroweb.org/guidelines/urethral-strictures/chapter/diagnostic-evaluation

  Urinalysis is an essential component of the work up of patients with LUTS. If infection is suggested, urine culture should be performed to confirm the diagnosis and identify the causative organism and sensitivity to antibiotics. […] A reduced maximum flow rate with a prolonged plateau is characteristic of the constrictive obstruction caused by urethral stricture. […] Retrograde urethrography (RUG) has widely been used as the investigation of choice for evaluating the stricture presence, location, length, and any associated anomalies (e.g., false passages, diverticula). […] The reported sensitivity and specificity of RUG in the diagnosis of strictures is 91% and 72%, respectively. […] Cystourethroscopy allows for accurate visual detection of a suspected stricture or can rule out a stricture as cause of obstructive voiding.

• #1 Urethral Stricture: Causes, Symptoms, and Prevention

  https://www.healthline.com/health/urethral-stricture

  Urethral stricture can cause numerous symptoms, ranging from mild to severe. Some of the signs of a urethral stricture include: […] How is urethral stricture diagnosed? Doctors may use several approaches to diagnose urethral stricture. […] To make a definite diagnosis of a urethral stricture, the doctor may also decide to perform one or more of the following tests: measuring the rate of flow during urination, analyzing the physical and chemical properties of urine to determine if bacteria (or blood) are present, cystoscopy: inserting a small tube with a camera into the body to view the inside of the bladder and urethra (the most direct way to check for stricture), measuring the size of the urethral opening, tests for chlamydia and gonorrhea.

• #1 Urethral Stricture: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/urethral-stricture.html

  Cystoscopy is used to inspect the stricture and to perform a biopsy if a malignant stricture is possible. […] The uroflowmetry curve has a pathognomonic plateau shape and a long voiding time. […] Healing (no recurrence of the stricture) is possible between 20-70%. […] Balloon urethral dilatation can cure epithelial strictures; strictures with marked spongiofibrosis will recur, comparable to the results of urethrotomy. […] Anastomotic urethroplasty is a definitive treatment option for short urethral strictures (2cm) with significant spongiofibrosis when initial urethrotomy recurs. […] Cure rates: 80-95%. […] A long-term cure of 80% is reported for patients with complex stricture disease or after failed hypospadias repair with long urethral defects. […] Partially good results were reported in small series with permanent (UroLume) or removable (Memokath) urethral stent implantation.

• #1 Diagnosing Urethral Stricture | NYU Langone Health

  https://nyulangone.org/conditions/urethral-stricture/diagnosis

  A urethral stricture is a narrowing of the urethra, the tube that carries urine out of the body. […] If you are experiencing urination problems, your doctor may ask about your medical history, perform a physical exam, and analyze a urine sample before ordering additional tests to determine the cause of your symptoms. […] During the uroflow screening test, a funnel-shaped collection device is used to measure the force of your urinary stream. […] In a postvoid residual test, ultrasound imaging of the bladder is performed immediately after urination. […] A cystoscopy procedure allows doctors to view the urethra to see if strictures are present. […] After a stricture is diagnosed, the length and degree of narrowing can be evaluated with a retrograde urethrogram.

• #1 stenosi dell’uretra: diagnosi, urethral disease: diagnosis

  http://www.uretra.it/stenosi-uretra-diagnosi-medici/?lang=en

  Diagnosis of urethral strictures requires a careful evaluation of the patients clinical history, a physical examination of the patient, as well as various clinical investigations. […] Ultrasonography: The exam is performed after the uroflowmetry and helps evaluate whether the patient succeeded in completely emptying the bladder by urinating. The presence of urine in the bladder after micturition can be related to urethral stricture. […] Urethrography: This radiological examination of the urethra is performed with the use of contrast medium. Retrograde and voiding urethrography is the most basic exam for studying the urethra. […] Urethral ultrasonography: This exam is performed using an auxiliary ultrasonic probe that is placed on the penis or perineum. […] Urethroscopy: This procedure is performed in an operating room with the patient under anesthesia to allow for an easy and painless exam. The examination consists in introducing a metal instrument into the urethra in order to visualize the urethral canal from the inside.

• #1 Urethral Stricture Diagnosis & Treatment | Mount Sinai – New York

  https://www.mountsinai.org/care/urology/services/reconstructive-urology/urethral-strictures

  If you experience unusual urinary symptoms or have difficulty urinating, you may have a urethral stricture. […] To test for a urethral stricture, we might perform a physical exam or one of these diagnostic tests: […] Imaging test with X-rays called a retrograde urethrogram (with contrast dye) to assess the length of the stricture and density of the stricture. […] Urine flow test and ultrasound to see how the urine flow is affected by the urethral stricture. […] Cystoscopy, where we gently insert a small, bendable, lubricated fiberoptic scope into your urethra under local anesthesia to see the location and appearance of the stricture.

• #1 Urethral Stricture Diagnostic Evaluation | World-Renowned Specialist

  https://centerforreconstructiveurology.org/urethral-stricture/urethral-stricture-diagnostic-evaluation/

  The retrograde urethrogram (RUG), which is in countries outside the USA also called an ascending urethrogram, is performed with the patient in the oblique position. […] The VCUG is the best study to evaluate the posterior urethra. […] Together, the RUG and VCUG provide an evaluation of the entire anterior and posterior urethra.

• #1 Urethral Stricture: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/urethral-stricture.html

  Urethral stricture is a fixed narrowing of the urethra with variable amounts of fibrotic tissue (Gozzi et al., 2008a) (Peterson et al., 2004). […] Urethral stricture is more common in the elderly population. […] The causal relationship between infection and urethral stricture has not been established for other urethritis pathogens. […] Risk factors for urethral stricture after catheterization are latex catheters, thick lumen catheters, ICU patients, and urinary tract infections. […] Correctly determining the stricture length is essential for treatment decisions; images with a perpendicular beam path to the urethra are necessary. […] VCUG is used for imaging of proximal strictures and may be combined with retrograde urethrography to judge stricture length. […] Ultrasound imaging of urethral strictures is possible with a perineal or penile probe position after filling the urethra with lubricant gel.

• #1 Urethral Stricture – Causes, Symptoms, Complications, Diagnosis & Treatment

  https://www.medindia.net/health/surgical-procedure/urethral-stricture.htm

  In antegrade urethrography, the contrast is introduced into the urinary bladder through a suprapubic catheter, a catheter directly introduced into the urinary bladder, or through the urethra, and images are taken while the patient passes urine. […] Cystoscopy is a procedure where an endoscope is introduced through the urethra into the urinary bladder to examine the inner surface of the urethra and urinary bladder. […] Ultrasound can be used to evaluate the stricture especially before surgery and to check the post-void volume of urine retained within the bladder. High post void urine makes it prone to infection.

• #1 EAU Guidelines on Urethral Strictures – Uroweb

  https://uroweb.org/guidelines/urethral-strictures/chapter/diagnostic-evaluation

  Ultrasound of the urethra or sonourethrography (SUG) provides a non-invasive three-dimensional assessment of anterior urethral stricture disease; including stricture location, length, and the degree of associated spongiofibrosis. […] Magnetic resonance imaging (MRI) has been used to image PFUIs, posterior urethral stenoses and anterior urethral strictures.

• #1 Urethral stricture | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/urethral-stricture?lang=us

  Urethral strictures are relatively common and typically occur either in the setting of trauma or infection. […] The primary mode of presentation of a symptomatic stricture is with poor urinary stream. If severe, bladder hypertrophy and trabeculation may occur. […] Radiographic evaluation helps define the location, length, number, and degree of strictures. […] Retrograde urethrography is the primary method used to image anterior urethral stricture. […] Sonourethrography is best used adjunctively to guide treatment planning in patients with known bulbous urethral strictures and has been reported to be more accurate than retrograde urethrography for estimating the length of urethral strictures. […] Treatment options include urethral dilation, direct vision internal urethrotomy (DVIU), permanent urethral stenting, and/or urethroplasty +/- graft/flap. […] Urethral strictures should not be confused with physiologic narrowing of the lumen at the level of membranous part of the urethra.

• #1 Urethral Strictures in Males Workup: Approach Considerations, Imaging Studies, Diagnostic Procedures

  https://emedicine.medscape.com/article/450903-workup

  The diagnosis of urethral strictures is based on a suggestive history, findings on physical examination, and radiographic or endoscopic visualization. The entire urethra, both proximal and distal to the strictured area, must be evaluated endoscopically and/or radiographically prior to any surgical intervention. […] Oftentimes strictures are initially diagnosed with cystoscopy. However, cystoscopy can usually only determine the presence of stricture but cannot accurately delineate the length of the stricture because the proximal extent of stricture cannot be visualized through the small lumen. […] Accurately documenting the extent and location of the stricture is important so that the most effective treatment options can be offered to the patient. […] Endoscopic evaluation can be conducted by flexible or rigid cystourethroscopy. Flexible cystourethroscopy can be performed with little discomfort to the patient using only local anesthesia, such as 2% lidocaine jelly intraurethrally. Malignancy should be ruled out with an endoscopic biopsy when appropriate. Again, cystoscopy can usually only determine the presence of stricture but cannot accurately delineate the length of the stricture because the proximal extent of stricture cannot be visualized through the small lumen. Because of this, imaging such as retrograde urothrography should be performed before any surgical intervention on urethral stricture.

• #1 Urethral Stricture – AUA Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/urethral-stricture-guideline

  The clinical guideline on urethral stricture provides a clinical framework for the diagnosis of urethral stricture and includes discussion of initial management, urethroplasty, reconstruction, contracture, stenosis, special circumstances, and post-operative follow-up care. […] Clinicians should include urethral stricture in the differential diagnosis of patients who present with decreased urinary stream, incomplete emptying, dysuria, urinary tract infection, and after rising post-void residual. (Moderate Recommendation; Evidence Level: Grade C) […] After performing a history, physical examination, and urinalysis, clinicians may use a combination of patient reported measures, uroflowmetry, and ultrasound post-void residual assessment in the initial evaluation of suspected urethral stricture. (Clinical Principle)

• #1 Urethral Stricture – AUA Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/urethral-stricture-guideline

  Clinicians should use urethro-cystoscopy, retrograde urethrography, voiding cystourethrography, or ultrasound urethrography to make a diagnosis of urethral stricture. (Moderate Recommendation; Evidence Level: Grade C) […] Clinicians planning non-urgent intervention for a known stricture should determine the length and location of the urethral stricture. (Expert Opinion) […] Surgeons may utilize urethral endoscopic management (e.g., urethral dilation, direct visual internal urethrotomy) or immediate suprapubic cystostomy for urgent management of urethral stricture, such as discovery of symptomatic urinary retention or need for catheterization prior to another surgical procedure. (Expert Opinion) […] Surgeons may place a suprapubic cystostomy to promote urethral rest prior to definitive urethroplasty in patients dependent on an indwelling urethral catheter or intermittent self-dilation. (Conditional Recommendation; Evidence Level: Grade C)

• #1 Urethral Strictures in Males Guidelines: Guidelines Summary, European Association of Urology Guidelines

  https://emedicine.medscape.com/article/450903-guidelines

  The American Urology Association (AUA) released guidelines for the diagnosis and treatment of male urethral strictures in 2016 and amended them in 2023. Key recommendations for diagnosis include the following: Urethral stricture should be considered in the differential diagnosis of patients who present with decreased urinary stream, incomplete emptying, dysuria, urinary tract infection (UTI), and rising post-void residual urine volume. Clinicians should use urethro-cystoscopy, retrograde urethrography, voiding cystourethrography, or ultrasound urethrography to diagnose urethral stricture. Perform biopsy for suspected lichen sclerosus (LS), or if urethral cancer is suspected. […] The guidelines offer the following diagnostic algorithm for males with suspected urethral strictures: Initial testing consists of uroflowmetry and estimation of post-void residual urine volume. Combine retrograde urethrography with voiding cystourethrography to assess nearly-obliterative strictures, stenoses, and pelvic fracture urethral injuries. Perform cystourethroscopy if further information is required. Combine retrograde urethroscopy and antegrade cystoscopy to evaluate pelvic fracture urethral injuries. Consider MRI urethrography as an ancillary test in posterior urethral stenosis.

• #1 Urethral Strictures in Males Guidelines: Guidelines Summary, European Association of Urology Guidelines

  https://emedicine.medscape.com/article/450903-guidelines

  In men considering surgery, retrograde urethrography is required to assess stricture location and length. Assessment of patient-derived benefit from surgery should be considered. Validated patient-reported outcome measures (PROM) should be administered to assess symptom severity and impact on quality of life, and to assess sexual function.

• #1

  https://link.springer.com/article/10.1007/s11934-019-0933-1

  In this review, we describe the incidence, diagnosis, and management of urethral strictures in women. […] Urethral strictures in women are very rare. When they do occur, they are often difficult to diagnose, requiring a high index of suspicion. Women with urethral strictures often present with symptoms of obstructed urinary flow, such as incomplete emptying, straining, and elevated postvoid residual. […] First line, minimally invasive treatment consists of urethral dilation and urethrotomy, though urethrotomy is rarely performed. Repeat urethral dilation has low success rates compared with urethroplasty, which is a more definitive treatment.

• #1 EAU Guidelines on Urethral Strictures – Uroweb

  https://uroweb.org/guidelines/urethral-strictures/chapter/disease-management-in-females

  The symptoms of female urethral strictures are non-specific and therefore generally non-diagnostic. Female urethral stricture presents with mixed filling and voiding symptoms with frequency in 63%, urgency in 55%, incomplete emptying in 36%, poor flow in 32%, urinary incontinence in 31% (stress, urge or mixed), strain void in 21.5%, UTI in 20.5%, nocturia in 20.5%, and dysuria in 20%. It very rarely presents with urethral pain (2.7%), terminal dribble (2%), haematuria (1.6%) or renal failure (0.5%) (see supplementary Table S7.1). […] There is often a significant delay in diagnosis of FUS from time of development of symptoms with mean delays of 4.3-12 years described (range 1-30 years). […] Twenty-four studies detail investigations leading to a diagnosis of FUS (see supplementary Table S7.2). In all cases a full history was taken, and a detailed pelvic examination was performed to assess for prolapse, masses, scars and vulval dermatological disorders such as LS, lichen planus or vulvo-vaginal atrophy. Flow rate and US PVR assessment was evaluated in nineteen (75%) and eighteen (71%) studies, respectively. Lateral VCUG was performed routinely in sixteen studies (63%) and as required in one study (4%). Cystourethroscopy was performed routinely in fourteen studies (54%) and as required in two studies (8%). Urodynamics (UDS) were performed routinely in four studies (17%) and as required in seven studies (30%), whilst video-urodynamics (VUDS) were performed routinely in three studies (13%), and urethral calibration in four studies (13%). Pelvic MRI was performed as required in four series (17%), whilst transrectal US (TRUS) and renal US were each performed routinely in two series (8%), and intravenous urography (IVU) in ten (4%).

• #1 Urethral Strictures – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564297/

  Uroflowmetry is the preferred initial investigation as it provides a good, noninvasive assessment of the maximum urethral flow. […] Cystoscopy is a relatively straightforward investigative procedure that quickly and definitively diagnoses urethral strictures. […] Retrograde urethrography can visualize the entire urethra up to the bladder if the patient is sufficiently relaxed. […] Combining a retrograde urethrogram and simultaneous cystogram or voiding cystourethrography yields an excellent image of the entire urethra. […] Urethroplasty provides the best long-term outcomes, with an overall success rate of 85%. […] Paclitaxel-coated urethral balloon dilation combined with DVIU has shown to be an effective long-term treatment option for bulbar strictures 3 cm in length.

• #1 Urethral Stricture Disease – Treatments from Comprehensive Urologic Care

  https://compurocare.com/urethral-stricture/

  A urethral stricture is a narrowing of the urethra due to scar tissue, which may block the flow of urine and cause inflammation and infection. […] To diagnose urethral stricture, physicians will begin by performing a physical exam, to rule out other problems. Next, the physician may order a urine culture to rule out infection. If there is no infection, the physician may order imaging tests, such as an x-ray or ultrasound, to produce images of the urethra. If a stricture is present, the imaging tests will determine its severity and complexity. […] If these tests are inconclusive or indicative of a urethral stricture, the physician may perform a cystoscopy and examine the bladder by inserting a lighted scope through the urethra via a catheter. Urodynamic tests may also be conducted to assess how well the bladder and the urethra are storing or releasing urine. These tests measure urinary flow in terms of speed and volume (uroflowmetry) and pressure (pressure flow study).

• #1 Urethral Stricture: Etiology, Investigation and Treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3627163/

  Urethral strictures can be caused by diagnostic or therapeutic urological procedures. […] Strictures are diagnosed with a flow test and a retrograde urethrogram. […] Urethral stricture can be diagnosed on the basis of its typical profile on uroflowmetry. […] The graph from a patient with a urethral stricture will show an extended urination time with a low-level plateau. […] The shape of this curve is pathognomonic of urethral stricture, although the investigation says nothing about the length of the stricture or where it is located. […] For this reason, urethroscopy does not have a major role in the diagnostic work-up of urethral stricture. […] Strictures can be reliably diagnosed on the basis of uroflowmetry and cystourethrography.

• #1 Urethral Stricture – Causes, Symptoms, Complications, Diagnosis & Treatment

  https://www.medindia.net/health/surgical-procedure/urethral-stricture.htm

  Urethral stricture is diagnosed based on the medical history and examination of the patient, and certain tests. The patient may give a history of suffering from a previous gonorrheal infection, or prior injury or surgical procedure on the urethra. The stricture may be obvious on examining the penis. The following tests are required in a patient with suspected urethral stricture: […] A urine test is done to diagnose the presence of a urinary tract infection. […] A uroflow study is done to note the extent of obstruction. […] Urethrography is the study of the passage of a contrast medium through the urethra, which helps to identify the stricture, its location and its extent. In retrograde urethrography, the contrast is introduced through a catheter into the urethra, and images are taken while it passes through the urethra, which help to identify the stricture and its length.

• #1 Urethral Stricture Diagnosis and Treatment

  https://www.verywellhealth.com/urethral-stricture-overview-4176296

  The diagnosis of a urethral stricture starts with a physical examination by a healthcare provider. If a urethral stricture is suspected, imaging studies such as an ultrasound or X-rays may be done. […] Urethroscopy is a procedure using a fiber optic scope to look in the urethra when a stricture is suspected. A retrograde urethrogram is a procedure where contrast dye is injected into the urethra to see how many strictures there are, and their position, length, and severity. The urethrogram is typically done for patients who have had a pelvic fracture or trauma and is often used to determine if surgery may be necessary. […] Treatment may be done on an emergent basis for a stricture that is causing a complete inability to urinate or when found incidentally during planned surgical procedures.

• #1 What is Urethral Stricture? Urethral Stricture Symptoms, Diagnosis and Treatment Methods

  https://drabdullaharmagan.com/en/what-is-urethral-stricture-urethral-stricture-symptoms-diagnosis-and-treatment-methods/

  When the urethra is narrowed, the patient cannot urinate comfortably. The urine accumulated in the bladder cannot be emptied sufficiently. […] If there are symptoms, a urinalysis, urine culture, blood creatinine level should be checked first. Later, urinary tract ultrasonography and uroflowmetry tests should be performed. […] When necessary, urethrography examination should be performed by giving medicated fluid to the urinary tract. As a result, urethral stricture is diagnosed, and the location and length of the stricture are determined.

• #1 Diagnosis of Urethral Stricture or Narrowing – ROC Clinic

  https://rocclinic.com/en/stenosis-or-narrowing-of-the-urethra/diagnosis/

  To diagnose urethral stricture, tests are performed that analyze the bladder capacity, the state of the urinary tract and the strength of the urinary muscles, among other aspects that are discussed below. […] The diagnosis is made on the basis of the symptoms presented by the patient and the results of the following diagnostic tests: […] It is a harmless test that measures the flow of urination. […] After flowmetry it is important to measure the residual, i.e. the amount of urine remaining in the bladder after voiding is completed. […] This test makes it possible to observe the urethra from the inside to detect areas of narrowing and the appearance of the mucosa. […] It consists of the introduction of iodinated contrast into the bladder until the patient indicates that he/she has the urge to urinate. […] It allows to know the diameter of the stenosis thanks to the use of a dilator (plug). […] The symptoms of urethral stricture are very common to other diseases of the urinary tract or prostate. Therefore, to confirm the problem it is necessary to perform diagnostic tests.

• #1 Urethral Strictures – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564297/

  Urethral strictures are a common yet often overlooked urological condition characterized by the narrowing of the urethra, which can lead to various urinary symptoms and complications. […] Understanding the basics of urethral strictures is essential for healthcare professionals to diagnose, treat, and manage this condition effectively. […] Patients with obstructive urinary symptoms who do not respond to standard therapy, such as men treated with alpha-blockers for benign prostatic hyperplasia, should be suspected of having a possible urethral stricture. […] Diagnostic measures are discussed, and definitive therapies are summarized, including intermittent self-catheterization/dilation and paclitaxel-coated urethral balloon dilation therapy. […] Cystoscopy, retrograde urethrography, or voiding cystourethrography make and confirm the diagnosis of urethral strictures.

• #1 Are You Suffering These Telltale Signs of Urethral Stricture Disease? : Paul H. Chung, MD, FACS: Reconstructive Urologist

  https://www.paulchungmd.com/blog/are-you-suffering-these-telltale-signs-of-urethral-stricture-disease

  Urethral stricture disease is a narrowing of the urethra. […] Dr. Paul Chung and his highly qualified staff are experienced in diagnosing and treating urethral stricture disease. […] Once Dr. Chung diagnoses urethral stricture disease, he may want imaging tests or other diagnostics to determine exactly where your stricture is located. […] The location and size of the stricture helps him decide on the best treatment options. […] Several types of surgical intervention can be appropriate for urethral strictures. […] Working with a doctor who understands all of those factors and who has experience with reconstructive surgery is the best path to achieve outstanding results.

• #1 Urethral stricture: Causes, symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/324983

  A doctor will first take a full medical history to help diagnose the underlying cause of urethral strictures. […] They may also recommend various testing methods to identify urethral problems. Tests include: […] A doctor will use information from diagnostic studies to determine the severity of the urethral stricture and how it impacts surrounding structures.

• #1

  https://www.urologycentersalabama.com/urethral-stricture/

  Once a stricture develops inside your urethra, it does not go away spontaneously. Medications do not treat the disease, but they can be helpful with managing symptoms. Surgical procedures are the most effective form of treatment. […] Urethral Dilation […] This procedure manually widens the scar within the urethra by passing rods through the diseased area. This procedure may not be curative for the stricture disease, and therefore may require repeat treatment to keep the urethra open. It can be done while the patient is awake with local anesthetic or asleep with general anesthesia. […] Direct Vision Internal Urethrotomy […] DVIU is a procedure performed under general anesthesia. A telescopic camera is used to visualize the stricture within the urethra. A tiny knife or a laser fiber is used to cut into the stricture, widening the urethral caliber. A catheter is then inserted into the urethra and remains there for 1-2 weeks to allow the area to heal.

• #1 Urethral Stricture Disease | Symptoms, Diagnosis & Treatments | MedStar Health

  https://www.medstarhealth.org/services/urethral-stricture-disease

  Urethral stricture results from inflammation or injury to the urethra. This results in scarring and narrowing of the urethra. […] Treatment options for urethral stricture disease vary depending on the length, location, and degree of scar tissue associated with the stricture. […] An initial urethrotomy (cutting the stricture using a telescope) or a dilation (stretching with rods/balloon dilator) should be considered in all patients with a urethral stricture. […] Surgical repair is another option that your physician may explore. An open urethroplasty may be performed for longer, more severe strictures. A reconstructive procedure (urethroplasty) gives the best chance of cure from a urethral stricture.

• #1 Get Urethral Stricture Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/urethral-stricture-treatment

  They may also order tests to help confirm the diagnosis. […] Youll likely start noninvasive testing, like a post-void residual urine test. While it cant diagnose urethral stricture, this test lets us see how well your bladder empties. If your provider feels you may have urethral stricture, you may also have an X-ray or a cystoscopy, which helps us see inside your urethra. […] Providers from different specialties work together to confirm your diagnosis and make sure you have the most personalized treatment for your needs and goals. […] The type of treatment you have will depend on what we learn from your tests. […] Your provider might recommend: […] Once you complete treatment for urethral stricture, youll have regular visits with your urology care team to make sure everything looks good and that the stricture hasnt come back. […] When you have a urethral stricture, getting care as soon as possible can give you the best results for recovery.

• #1 Urethral Stricture Disease | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/adult-urology/urethral-stricture-disease

  There are several tests to determine if you have a urethral stricture including: physical exam, urethral imaging (X-rays or ultrasound), urethroscopy (to see the inside of the urethra), retrograde urethrogram. […] The doctor gently places a small, bendable, lubricated scope (a small viewing instrument) into the urethra. It is moved up to the stricture. This lets the doctor see the narrowed area. This is done in the office and helps your doctor decide how to treat the stricture. […] This test is used to see how many strictures there are, and their position, length and severity. This is done as an outpatient X-ray procedure. Retrograde in this case means „against the flow” of urine. Contrast dye (fluid that can be seen on an X-ray) is inserted into the urethra at the tip of the penis. No needles or catheters are used. The dye lets the doctor see the entire urethra and outlines the narrowed area. It can be combined with an antegrade urethrogram (antegrade means „with the flow” of urine). […] After the catheter is removed, your doctor will want to check you with physical exams and X-rays as needed. Sometimes the doctor performs urethroscopy to check the repair.

• #1 Narrowing of the urethra (urethral stricture): diagnostics & treatment (Engelse versie) | Amsterdam UMC

  https://www.amsterdamumc.nl/nl/patienteninformatie/narrowing-of-the-urethra-urethral-stricture-diagnostics-treatment-engelse-versie.htm

  A retrograde urethrogram is an X-ray taken by the urologist at the urology department. Contrast fluid is injected into the urethra, after which an X-ray is taken. The urologist can usually explain to you immediately what can be seen and what the best plan of action is. […] Based on your symptoms and examinations, your urologist will draw up a treatment plan together with you. […] A urethrotomy is an operation via the urethra in which the stricture is cut. This is only possible when a stricture is short (shorter than 2 cm). A urethrotomy is performed under general anesthesia or a spinal injection. […] Urethroplasty is a collection of open operations on the urethra. The two most important forms are end-to-end and onlay urethroplasty. […] After a urethroplasty, you will be monitored for another year. After the catheter has been removed, you will return to the outpatient clinic 3 more times over the course of 1 year to perform a uroflowmetry and to discuss how the recovery is going.

• #1 Urethral Stricture: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/urethral-stricture

  With treatment, urethral strictures generally have a positive outcome. […] Talk to a healthcare provider as soon as you can if you have symptoms of a urethral stricture, especially if the symptoms develop suddenly. […] See a healthcare provider if you have symptoms of a urethral stricture. Schedule regular appointments with a provider after treatment to ensure youre healing properly and the stricture isnt coming back. […] A urethral stricture occurs when scar tissue develops in your urethra.

• #1 Narrowing in on urethral strictures

  https://www1.racgp.org.au/ajgp/2021/april/narrowing-in-on-urethral-strictures

  If the GP suspects a urethral stricture is present, they can acquire these preliminary investigations while simultaneously referring onto a urology service. […] The urologist may subsequently arrange for a flexible cystoscopy and/or urethrography to establish the diagnosis. […] If untreated, urethral strictures can lead to significant complications including elevated post-void residual bladder volumes, a thick-walled trabeculated bladder, acute urinary retention, hydronephrosis, calculi formation, renal failure, urethral fistula and periurethral abscess. […] Therefore, early detection and prompt referral to a urologist is essential for reducing morbidity and mortality from urethral strictures. […] Urethroplasty is the open surgical reconstruction or replacement of a urethra that has been narrowed by scar tissue.

• #2 Urethral Stricture | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/urethral-stricture

  Urethral stricture is a narrowing in the urethra. This narrowing makes it difficult for urine to drain out. […] The narrowing may be congenital (present at birth) or the result of inflammation, injury, disease or prior surgery. […] In children with a urethral stricture, the urinary flow rate is decreased and it usually takes longer to empty the bladder. […] The radiologist looks to see if there is narrowing in the urethra. This will provide us with the location of the narrowing, the degree of narrowing and if any other malformations are noted. […] Treating the urethral stricture depends on the location and length of the stricture. […] A cystoscope is a small device with a light and a camera lens at the end. This provides direct visualization of the urethra and possible stricture. […] The stricture can be cut lengthwise with a blade, on the end of the instrument, to widen the urethra and allow urine to pass. […] The narrowed area of the urethra is removed and the remaining urethra is reconnected (anastamosis).

• #2 EAU Guidelines on Urethral Strictures – Uroweb

  https://uroweb.org/guidelines/urethral-strictures/chapter/diagnostic-evaluation

  Urinalysis is an essential component of the work up of patients with LUTS. If infection is suggested, urine culture should be performed to confirm the diagnosis and identify the causative organism and sensitivity to antibiotics. […] A reduced maximum flow rate with a prolonged plateau is characteristic of the constrictive obstruction caused by urethral stricture. […] Retrograde urethrography (RUG) has widely been used as the investigation of choice for evaluating the stricture presence, location, length, and any associated anomalies (e.g., false passages, diverticula). […] The reported sensitivity and specificity of RUG in the diagnosis of strictures is 91% and 72%, respectively. […] Cystourethroscopy allows for accurate visual detection of a suspected stricture or can rule out a stricture as cause of obstructive voiding.

• #2 Urethral Stricture: Etiology, Investigation and Treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3627163/

  Urethral strictures can be caused by diagnostic or therapeutic urological procedures. […] Strictures are diagnosed with a flow test and a retrograde urethrogram. […] Urethral stricture can be diagnosed on the basis of its typical profile on uroflowmetry. […] The graph from a patient with a urethral stricture will show an extended urination time with a low-level plateau. […] The shape of this curve is pathognomonic of urethral stricture, although the investigation says nothing about the length of the stricture or where it is located. […] For this reason, urethroscopy does not have a major role in the diagnostic work-up of urethral stricture. […] Strictures can be reliably diagnosed on the basis of uroflowmetry and cystourethrography.

• #2 Urethral stricture: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001271.htm

  Urethral stricture is an abnormal narrowing of the urethra. The urethra is the tube that carries urine out of the body from the bladder. […] A physical exam may show the following: Decreased urinary stream, Discharge from the urethra, Enlarged bladder, Enlarged or tender lymph nodes in the groin, Enlarged or tender prostate, Hardness on the under surface of the penis, Redness or swelling of the penis. […] Tests include the following: Cystoscopy, Postvoid residual (PVR) volume (usually by ultrasound), Retrograde urethrogram, Tests for chlamydia and gonorrhea, Urinalysis, Urinary flow rate, Urine culture. […] The urethra may be widened (dilated) during cystoscopy. […] If urethral dilation cannot correct the condition, you may need surgery. […] A surgery called an open urethroplasty may be done for longer strictures. […] The outcome is often excellent with treatment. […] Contact your health care provider if you have symptoms of urethral stricture. […] Treating a urethral stricture quickly may prevent kidney or bladder complications.

• #2

  https://www.urologycentersalabama.com/urethral-stricture/

  Once a stricture develops inside your urethra, it does not go away spontaneously. Medications do not treat the disease, but they can be helpful with managing symptoms. Surgical procedures are the most effective form of treatment. […] Urethral Dilation […] This procedure manually widens the scar within the urethra by passing rods through the diseased area. This procedure may not be curative for the stricture disease, and therefore may require repeat treatment to keep the urethra open. It can be done while the patient is awake with local anesthetic or asleep with general anesthesia. […] Direct Vision Internal Urethrotomy […] DVIU is a procedure performed under general anesthesia. A telescopic camera is used to visualize the stricture within the urethra. A tiny knife or a laser fiber is used to cut into the stricture, widening the urethral caliber. A catheter is then inserted into the urethra and remains there for 1-2 weeks to allow the area to heal.

• #3 Urethral Stricture Disease – Treatments from Comprehensive Urologic Care

  https://compurocare.com/urethral-stricture/

  A urethral stricture is a narrowing of the urethra due to scar tissue, which may block the flow of urine and cause inflammation and infection. […] To diagnose urethral stricture, physicians will begin by performing a physical exam, to rule out other problems. Next, the physician may order a urine culture to rule out infection. If there is no infection, the physician may order imaging tests, such as an x-ray or ultrasound, to produce images of the urethra. If a stricture is present, the imaging tests will determine its severity and complexity. […] If these tests are inconclusive or indicative of a urethral stricture, the physician may perform a cystoscopy and examine the bladder by inserting a lighted scope through the urethra via a catheter. Urodynamic tests may also be conducted to assess how well the bladder and the urethra are storing or releasing urine. These tests measure urinary flow in terms of speed and volume (uroflowmetry) and pressure (pressure flow study).

• #3 Urethral Strictures – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK564297/

  Uroflowmetry is the preferred initial investigation as it provides a good, noninvasive assessment of the maximum urethral flow. […] Cystoscopy is a relatively straightforward investigative procedure that quickly and definitively diagnoses urethral strictures. […] Retrograde urethrography can visualize the entire urethra up to the bladder if the patient is sufficiently relaxed. […] Combining a retrograde urethrogram and simultaneous cystogram or voiding cystourethrography yields an excellent image of the entire urethra. […] Urethroplasty provides the best long-term outcomes, with an overall success rate of 85%. […] Paclitaxel-coated urethral balloon dilation combined with DVIU has shown to be an effective long-term treatment option for bulbar strictures 3 cm in length.

• #4 Urethral Stricture – AUA Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/urethral-stricture-guideline

  Clinicians should use urethro-cystoscopy, retrograde urethrography, voiding cystourethrography, or ultrasound urethrography to make a diagnosis of urethral stricture. (Moderate Recommendation; Evidence Level: Grade C) […] Clinicians planning non-urgent intervention for a known stricture should determine the length and location of the urethral stricture. (Expert Opinion) […] Surgeons may utilize urethral endoscopic management (e.g., urethral dilation, direct visual internal urethrotomy) or immediate suprapubic cystostomy for urgent management of urethral stricture, such as discovery of symptomatic urinary retention or need for catheterization prior to another surgical procedure. (Expert Opinion) […] Surgeons may place a suprapubic cystostomy to promote urethral rest prior to definitive urethroplasty in patients dependent on an indwelling urethral catheter or intermittent self-dilation. (Conditional Recommendation; Evidence Level: Grade C)

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