N35.114

Clinical Causes: Previous urinary tract infections (UTIs), especially if recurrent or severe Infections caused by bacteria, viruses, or fungi that affect the urethra Trauma or injury to the urethra, often during catheterization or surgery Inflammatory conditions affecting the urethra Sexually transmitted infections that involve urethral inflammation Occasionally, unknown factors or mild injuries that lead to scarring after infection

Key Symptoms: Difficulty starting urination (hesitancy) Weak or interrupted urine stream Meatal stenosis (narrowing of the urethral opening) Frequent urination or a persistent feeling of incomplete bladder emptying Pain or a burning sensation during urination Blood in the urine (hematuria) in some cases Urinary retention in severe cases, where urine cannot pass at all

Diagnosis Path: Diagnosis typically involves a combination of medical history, physical examination, and specialized tests. These may include: - Urinalysis to detect infection or blood in the urine - Uroflowmetry to assess urine flow rate - Retrograde urethrogram, an imaging test where contrast dye is injected into the urethra and X-rays are taken to visualize narrowing - Cystoscopy, a procedure using a thin tube with a camera to look directly inside the urethra and bladder The goal of diagnosis is to determine the location, length, and severity of the stricture to guide treatment planning.

Treatment Protocols: Treatment options depend on the severity and extent of the urethral stricture. Common approaches include: - **Dilation**: Gradually stretching the narrowed part of the urethra using specialized instruments. - **Urethrotomy**: A surgical procedure that involves cutting the scar tissue to widen the urethral passage. - **Urethroplasty**: A more definitive surgical repair that removes or reconstructs the scarred segment of the urethra. - **Antibiotic therapy**: Used if an active infection is present, often in conjunction with surgical procedures. Long-term follow-up is essential to monitor for recurrence, as strictures may return after treatment. In some cases, stent placement or other interventions may be necessary for persistent or recurrent strictures.