N35.9

Clinical Causes: Infections, such as gonorrhea or other sexually transmitted infections Injury or trauma to the pelvic area or urethra History of urethral surgery or catheterization Inflammation or fibrosis resulting from repeated infections Congenital abnormalities present at birth Urethral tumors or growths Autoimmune conditions affecting the urethra

Key Symptoms: Difficulty starting urination Weak or interrupted urinary stream Dribbling after urination Frequency or urgency to urinate Pain or a burning sensation during urination Feeling of incomplete bladder emptying Rectal or perineal pain in some cases Urinary retention in more severe cases

Diagnosis Path: Diagnosing a urethral stricture typically involves a combination of medical history review and physical examination. Several tests may be conducted, including: - *Urethrography*: An imaging test where dye is injected into the urethra to visualize narrowing areas. - *Cystoscopy*: A procedure using a thin tube with a camera to examine the urethra and bladder. - *Uroflowmetry*: Measuring the flow rate of urine to assess obstruction. - *Post-void residual measurement*: Determining how much urine remains in the bladder after urination. These assessments help determine the location, length, and severity of the stricture.

Treatment Protocols: Managing urethral strictures can involve several approaches based on the severity and extent of the narrowing: - *Urethral dilation*: Gradually stretching the narrowed segment using a series of increasing-sized dilators. - *Urethrotomy*: A surgical incision made inside the urethra to widen the constricted area. - *Surgical reconstruction (urethroplasty)*: Removing the scar tissue and reconnecting healthy urethral tissue, typically reserved for more complex cases. - *Use of stents*: In certain situations, temporary or permanent stents may be placed to maintain the urethral lumen. Follow-up care and monitoring are essential to ensure the urethra remains open and to address any recurrence.