Many patients suffer from a condition called Urethral stricture, or a narrowing of the tube (Urethra) that carries urine out of the body. More often this is cause by scar tissue but can also be caused by procedures involving the insertion of an instrument, long term, or temporary use of a tube (Catheter), trauma or injury to the pelvis, enlarged prostate, cancer, radiation therapy and even sexually transmitted infections. The condition is far more common in males and a lot of times it is difficult to find an exact cause.
Patients suffering from stricture will experience some, or all of the following conditions: decreased blood in the urine, blood in semen, swelling of the penis, weak urine stream, incomplete bladder emptying, ‘spraying’ of the urine stream, difficulty, straining or pain while urinating, urinary tract infection and an increased urge to urinate or greater frequencies or urination. Stricture can be diagnosed by a trained urologist with a physical exam, imaging, or using an endoscope to visualize the path of the urethra.
In very severe cases your doctor may recommend a Retrograde Urethrogram. Performed as an x-ray procedure contrast dye is inserted into the urethra at the tip of the penis and the doctor can see the direction of flow, multiple strictures so that a treatment plan can be developed. It can be combined with an antegrade urethrogram, and dye inserted below fills the urethra to the injured area, dye inserted above fills the bladder and urethra down to the stricture. Your surgeon will use the results of this test to determine the best plan for your surgical procedure.
When surgery is not yet an option, your doctor may prescribe to you a Meatal Dilator. The meatal dilator is blue, made of polycarbonate and is supplied sterile in an individual peel-open package and is intended for single use. Your doctor will show you the correct way to use the product so that you can dilate the middle meatus muscle. The design is tapered and gradually gets larger as you insert the product. Always refer to the instructions for use for additional information that your doctor may not be able to provide.
If repeated attempts to treat the stricture are unsuccessful you will likely be a candidate for catheterization. This is when the doctor places a small tube into your bladder to drain urine and is often done in combination with antibiotics. Your surgeon may elect to sequentially dilate the urethra of which they will use the ACE Medical Dittel Bougies which range in size from eight Fr to thirty-four Fr. If your condition is severe your doctor may recommend a Urethroplasty, this is where they remove the portion that is diseased and replace it with a graft from somewhere else in the body, such as the skin or mouth. Additionally, they may replace the removed portion with a stent or permanent catheter.
Once your procedure is complete and you are discharged from the hospital or surgery center your doctor will likely recommend you use an incontinence clamp which can be used to prevent unwanted discharge of urine. The clamp is sizable with four positions and is an efficient way to stop urine flow without effecting blood circulation.