N35.010

Clinical Causes: Trauma or injury to the urethra, often from accidents, falls, or physical assaults Invasive medical procedures involving the urethra or prostate Urethral instrumentation, such as catheterization or cystoscopy Penile or pelvic fractures that impact the urethral area Injuries sustained during sexual assault or violent incidents Delayed healing after urethral surgeries leading to scar tissue formation

Key Symptoms: Difficulty starting urination Weak or interrupted urine stream Urinating frequently or feeling the need to urinate urgently Pain or discomfort during urination Blood in the urine (hematuria) Feeling of incomplete bladder emptying Urinary retention in severe cases

Diagnosis Path: The diagnosis involves a combination of medical history review and physical examination, focusing on any recent injuries or trauma. Diagnostic procedures may include: - Urethroscopy, to visually inspect the urethra - Voiding cystourethrogram (VCUG), an imaging test that evaluates urine flow and urethral narrowing - Retrograde urethrogram, which involves X-ray imaging after inserting contrast medium into the urethra - Uroflowmetry, a test measuring urine flow rate These assessments help pinpoint the location and severity of the stricture.

Treatment Protocols: Managing post-traumatic urethral strictures typically involves procedures aimed at restoring the urethral lumen and preventing recurrence. Treatment options include: - **Dilation:** gradually enlarging the narrowed area using special instruments - **Urethrotomy:** endoscopic incision of the stricture, - **Surgical repair:** excision of the scar tissue followed by reconstruction, often called urethroplasty - **Stent placement:** in some cases, temporary or permanent stents may be used to keep the urethra open - **Post-treatment care:** includes monitoring for recurrence and managing any associated urinary symptoms. Early intervention is key to reducing complications such as persistent obstruction or infection.