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Urethral Stricture
Urethral stricture is an uncommon condition that results in blockage of the urethra or “peeing tube.” Stricture formation results in a narrow circular ring of scar tissue, which restricts the flow of urine.
Signs and symptoms
Most men will experience symptoms, such as slow stream, frequent urination, feelings of incomplete emptying, recurrent infections and straining to void. In severe cases, urinary retention may prevent individuals from urinating and may require emergency intervention. In severely injured patients, blood in the urine may also be seen.
Causes
The cause of the majority of urethral strictures is unknown. The most common cause is trauma from being struck in the area between the legs, known as the perineum. Other causes include: inflammatory diseases, i.e., lichen sclerosis and balanitis xerotica obliterans; infections, i.e., sexually transmitted disease; congenital abnormalities; instrumentation, i.e., surgery, catheter placement or pelvic fracture.
Diagnosis
Patient evaluation starts with a thorough history and physical. The majority of patients will require a retrograde urethrogram, or RUG. This is an outpatient x-ray test that shows the location, density, and length of the urethral stricture and is required for planning a repair. Other additional tests can include insertion of a camera into the bladder, called cystoscopy.
Treatment
The treatment for urethral stricture is customized to fit each individual patient. Most urethroplasties require an overnight stay in the hospital.
Our doctors
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Accepting New Patients
Joshua A Broghammer
UrologyLocations:- The University of Kansas Hospital
- 4000 Cambridge Street
- Kansas City, KS 66160
Clinical Focus:- Urology
We offer a variety of appointment types. Learn more or call 913-588-1227 to schedule now.
So the procedure that we just did today is actually a repairing a deep bulbar urethral stricture. So deep in this particular patient, he had an area that was starting to narrow and was not allowing him to urinate. So what we did is take a piece of the inside of his mouth, harvested by one of our ENT colleagues, we defatted that on the back table here.
Opened up the strictured area so the strictured area came down narrowed like an hour glass.
OK, so normal urethra is up here. Move. Right in there. That's wide open. In fact you see how nice that looks. Wide open.
Then you can see it starts getting diseased right in here and then you can actually see this little, it's almost like a little cliff sitting there, a little ledge. And that's the strictured area and then it gets normal again right back here. You see it? Suck there. Suck underneath here. So it's normal opening right there.
What we're doing is we're gonna put the flap in right in here. So we're gonna be putting this flap in right in here so you can see the little strictured area there. This is normal. This normal. We're going to be suturing it all in here. We opened that up, measured how much we needed. Sutured the inside of what's called buccal mucosa, which is the lining on the inside of the mouth.
That lining we measured and then sutured that with the skin side or the mucosa side, which is the portion you touch with your tongue in toward the urethra. We sutured all of that in and once that's sutured in we've now given a wider caliber to the urethra so this gentleman will be able to urinate.
Now, that graft has to take. In other words, it has to recruit its own blood supply so that will take two days or so while this patient is on bedrest. They have very little discomfort from it.
There aren't many places doing this in the country. In fact, we have one of the largest series in the country and so this is sort of a specialty specific procedure that we do that I think has been very successful. We actually have a 96 percent success rate and we followed our patients now for up to five years.