Presentation
Presentation on theme: "Urethral stricture. *May be congenital or acquired. *Acquired urethral sricture is common in men but rare in women. Aetiology 1. congenital 2. Traumatic. [slideplayer.com]
Present On Admission POA Help "Present On Admission" is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery [icd10data.com]
Risks include: Sexually transmitted infection (STI) Procedures that place a tube into the urethra (such as a catheter or cystoscope) Injury to the pelvic area Repeated urethritis Strictures that are present at birth (congenital) are rare. [wexnermedical.osu.edu]
Congenital anterior urethral diverticulum with stone a unique presentation. Urology 2003;61:837. [Figure 1], [Figure 2] [mjdrdypu.org]
According to this classification; the present case was type II A-2 (complete urethral duplication with the second urethra arising from first one and coursing independently into separate meatus). Clinical presentation varies from type to type. [f1000research.com]
Entire Body System
- Inflammation
Urethral stricture, or narrowing of the urethra, also can be caused by developmental conditions as well as by inflammation, infection, or injury. [britannica.com]
Infection of urethra can be caused by sexually transmitted diseases like gonorrhoea, chlamydia, or can be as a result of long term use of catheter, and infection can cause inflammation in an around the tissues of the urethra. [specialistshospital.com]
The following causes may sometimes lead to urethral strictures as a result of persistent urtheritis (inflammation of the urethra) or damage to the urethral wall. [healthhype.com]
Trauma during catheterization or cystoscopy Sexually transmitted diseases Repeated inflammation of the urethra, also called as urethritis. Injury in the pelvic region. [drelist.com]
They include Urethral cancer - a rare cancer that happens more often in men Urethral stricture - a narrowing of the opening of the urethra Urethritis - inflammation of the urethra, sometimes caused by infection Urethral problems may cause pain or difficulty [icdlist.com]
- Recurrent Urinary Tract Infection
It is not considered a rare disease, and we must note the existence of such anomaly, especially in boys suffering from recurrent urinary tract infections, dysuria, disturbed voiding, drug- resistant diurnal enuresis, pollakisuria or hematuria in pediatric [link.springer.com]
But in our experience congenital urethral stenosis is an important cause of recurrent urinary tract infections, enuresis, pollakisuria or hematuria in pediatric urological practice. It also disturbs spontaneous healing of vesicoureteral reflux. [ncbi.nlm.nih.gov]
Last conclusions The first is to make an accurate diagnosis before symptoms that can be mistaken for a prostate condition in male or a problem of recurrent urinary tract infections or painful bladder in women. [topdoctors.es]
[…] in periurethral gland, anterior urethral valve, calculosis, syringocoele or Cobb's collar, and hypospadiasis. [5] Clinically, diverticulum may present as recurrent urinary tract infection, penoscrotal mass in males, [6] or anterior vaginal wall swelling [mjdrdypu.org]
- Falling
Urethral trauma is at three different levels- Penile -Direct penetrating injury Bulbar- Falling on a frame of a bicycle between the legs or a perineal kick Membranous- Pelvic fracture urethral distraction defects After surgery: Previous prostate surgery [cureurethralstricture.com]
Trauma – Impact from a car accident or a fall can damage the urethra. In some cases, the cause of urethral strictures is unknown. [tuh.templehealth.org]
Trauma Mechanical trauma during catheterization or cystoscopy Damage due to passing kidney stones Radiation therapy Injury from a fall, blow or chemicals that enter the urethra Prostate surgery, circumcision Infections Urinary tract infections (UTIs) [healthhype.com]
Damages caused by radiotherapy and by accidental falls etc may also cause damages to the urethra. [specialistshospital.com]
According to the Center for Reconstructive Urology, straddle injury resulting from falling off a bicycle or getting hit in the scrotum is one of the most common injuries that may lead to urethral strictures. Benign prostatic hypertrophy. [drelist.com]
- Surgical Procedure
SURGICAL PROCEDURES FOR URETERAL INJURY AND CONGENITAL CONDITIONS In addition to urethroplasty for stricture disease, Dr. [chesapeakeurology.com]
Urethroplasty – This is a surgical procedure that aims to enlarge the urethra or remove the part of it that has narrowed. [drmasel.com]
Many surgical procedures are available for treating urethral strictures. Depending on the cause and other medical and social aspects, the most appropriate procedure may be recommended for each individual case. [laparoscopyhospital.com]
http://www.dovemed.com/common-procedures/procedures-surgical/hypospadias-repair/ Reviewed and Approved by a member of the DoveMed Editorial Board First uploaded: March 15, 2016 Last updated: Dec. 24, 2018 [dovemed.com]
Detailed knowledge of urethral duplication is important when planning for any surgical procedure for its correction. Many patients are asymptomatic and do not require any surgery. [f1000research.com]
- Pediatric Disease
He has a wide experience for more than 30 years in the field of pediatric surgery with a special interest in pediatric urology, rare genitourinary anomalies, pediatric gynaecology, and Hirschsprung’s disease. [books.google.com]
Respiratoric
- Dyspnea
In August 2007, after seven cycles, he presented with dyspnea and cough. A computed tomography (CT) scan of the chest showed features suggestive of bleomycin-induced pulmonary toxicity. Pulmonary function tests revealed obstructive airway disease. [indianjurol.com]
Gastrointestinal
- Lower Abdominal Pain
Symptoms Dysuria (painful urination) Difficulty urinating Slow urine stream (may develop suddenly or gradually) Spraying of urine stream Decreased urine output Increased urinary frequency or urgency Incontinence Blood in the semen Pelvic pain Lower abdominal [readycureayurveda.com]
[…] and/or cystitis ) Other signs and symptoms that may be due to the stricture itself or causative pathology may include : frequent urination pelvic and/or lower abdominal pain urinary incontinence blood in the semen (hematospermia) blood in urine (hematuria [healthhype.com]
Neurologic
- Burning Sensation
Dribbling of urine after urination and symptoms and signs of urinary infections such as painful urination, burning sensation and frequent urge to urinate may occur as well. [ic.steadyhealth.com]
The following complaints may occur in case of a strictured urethra: Weak urinary stream or incontinence: the urinary stream might be twisted or split Burning sensation during urination Incomplete bladder voiding: Patients sense residual urine in the bladder [mukocell.com]
The main symptoms are acute urinary retention, frequency, a burning sensation in the urethra during urination, a burning sensation in the perineum and/or rectum, or a stinging in the anus. [bmcresnotes.biomedcentral.com]
A burning sensation in the urethra was persistent for some time after micturition. There was no hematuria or turbid urine. His urine was sterile and the symptoms subsided after symptomatic treatment. [indianjurol.com]
Urogenital
- Incontinence
[…] cancer gallbladder disease genitourinary neoplasm glomerular disease glomerulonephritis gout hepatic encephalopathy hepatorenal syndrome hydronephrosis hypospadias incontinence interstitial cystitis interstitial nephritis kidney cancer kidney disease [nyulangone.org]
Symptoms and signs of epispadias are incontinence, reflux, and UTIs. Treatment of epispadias is surgical. In partial epispadias, prognosis for continence with treatment is good. [msdmanuals.com]
In complete epispadias, surgical reconstruction of the penis alone may lead to persistent incontinence; bladder outlet reconstruction is required to achieve complete urinary control. [merckmanuals.com]
Long-term complications included painful erections (44%), mucous hyperplasia (44%), recurring stricture (29%), and incontinence (14%). Additionally, some unique complications are associated with permanently implantable stents. [emedicine.medscape.com]
- Urinary Retention
When associated with bladder tumors, recurrent infection, or urinary retention, bladder diverticula will need treatment. [urologyaustin.com]
In cases of acute urinary retention, a catheter may be placed as an emergency treatment. This allows the bladder to drain through the abdomen. When no other options are available, a urinary diversion may be done. [wexnermedical.osu.edu]
[…] pain Bloody or dark urine Discharge from the urethra Swelling of the penis Urinary retention A physical examination may reveal the following: Decreased urinary stream Enlarged or tender lymph nodes in the inguinal (groin) areas Redness or swelling of [readycureayurveda.com]
Possible complications of urethral strictures in males Sudden acute urinary retention is the most serious complication of urethral strictures. It is an emergency situation that needs to be dealt on an urgent basis. [drelist.com]
[…] starting urine flow Painful urination (dysuria) Urinary tract infection (UTI) Urinary retention Incomplete emptying of bladder Decreased urine stream Dribbling of urine Spraying or double streaming urine Blood in the urine (hematuria) Blood in the semen [laparoscopyhospital.com]
- Dysuria
Irritative urinary symptoms & dysuria due to cystitis. 5. Acute or chronic urine retention. 6.Complications due to urethral stricture: a. Chronic prostatitis b. periurethral abscess & urethrocutaneous fistula. c. [slideplayer.com]
It is not considered a rare disease, and we must note the existence of such anomaly, especially in boys suffering from recurrent urinary tract infections, dysuria, disturbed voiding, drug- resistant diurnal enuresis, pollakisuria or hematuria in pediatric [link.springer.com]
Symptoms Bloody or dark urine Decreased urine output Difficulty urinating Discharge from the urethra Frequent or urgent urination Inability to urinate (urinary retention) Incontinence Painful urination (dysuria) Pain in the lower abdomen Pelvic pain Slow [wexnermedical.osu.edu]
Symptoms Dysuria (painful urination) Difficulty urinating Slow urine stream (may develop suddenly or gradually) Spraying of urine stream Decreased urine output Increased urinary frequency or urgency Incontinence Blood in the semen Pelvic pain Lower abdominal [readycureayurveda.com]
- Hematuria
hematuria N3031Trigonitis with hematuria N3040Irradiation cystitis without hematuria N3041Irradiation cystitis with hematuria N3080Other cystitis without hematuria N3081Other cystitis with hematuria N3090Cystitis, unspecified without hematuria N3091Cystitis [cms.gov]
チャンス血尿(Asymptomatic hematuria 無症候性血尿) chance proteinuriaチャンス蛋白尿 chancroid軟性下疳 Chlamydia infectionクラミジア感染症 chronic glomerulonephritis (CGN)慢性糸球体腎炎 chronic kidney disease (CKD)慢性腎疾患 chronic nephritic syndrome慢性腎炎症候群 chronic renal failure (CRF)慢性腎不全 colicky [tokyo-med.ac.jp]
It is not considered a rare disease, and we must note the existence of such anomaly, especially in boys suffering from recurrent urinary tract infections, dysuria, disturbed voiding, drug- resistant diurnal enuresis, pollakisuria or hematuria in pediatric [link.springer.com]
But in our experience congenital urethral stenosis is an important cause of recurrent urinary tract infections, enuresis, pollakisuria or hematuria in pediatric urological practice. It also disturbs spontaneous healing of vesicoureteral reflux. [ncbi.nlm.nih.gov]
- Urinary Incontinence
[…] and/or cystitis ) Other signs and symptoms that may be due to the stricture itself or causative pathology may include : frequent urination pelvic and/or lower abdominal pain urinary incontinence blood in the semen (hematospermia) blood in urine (hematuria [healthhype.com]
Vesicovaginal fistula (VVF) Vesicovaginal fistula (VVF) is an abnormal opening between the bladder and the vagina that results in continuous and unremitting urinary incontinence. [goelkidneycare.com]
Acquired Female Urethral Diverticula • The diagnosis of female urethral diverticula is being made with greater frequency owing to awareness of the condition and of its coexistence with stress urinary incontinence and urinary infection. • Urethral diverticulum [slideshare.net]
The condition results in difficulty while urinating, blood in the urine, abdominal pain, and even urinary incontinence A treatment of Urethral Stricture in Women may involve cystoscopy, surgical procedures, such as urethroplasty, and the placement of [dovemed.com]
Workup
X-Ray
- Nephrolithiasis
メサンギウム細胞 metastatic carcinoma転移性癌 microscopic hematuria顕微鏡的血尿 micturition hyperreflexia 排尿反射亢進 micturition reflex 排尿反射 minimally invasive therapy低侵襲治療 mycobacteriaミコバクテリア、マイコバクテリア n needle biopsy針生検 neobladder 新膀胱 nephrectomy腎摘出[術]、腎摘、腎切除[術] nephritis腎炎 nephrolithiasis [tokyo-med.ac.jp]
Cystoscopy
- Bladder Trabeculation
It causes restricted urine flow, proximal urethral dilation,bladder wall trabeculations & hypertrophy & later postvoid residue. 5 6 Clinical picture 1. Reduced urine stream. 2. Disturbed stream(double stream) with post void dribbling. 3. [slideplayer.com]
Note also the bladder wall thickening and trabeculation. (b) Transverse US image through the bladder shows significant thickening of the bladder wall (arrows). 44. Posterior urethral valves with bilateral vesicoureteral reflux. 45. [slideshare.net]
Treatment
The final chapter deals with the etiology, pathology, clinical diagnosis, and treatment of priapism. This book is a valuable resource for physicians. [books.google.com]
This is an emergency treatment. This allows the bladder to drain through the abdomen. There are currently no drug treatments for this disease. [medlineplus.gov]
This also helps to guide the treatment course. [urology.ucla.edu]
This innovative method of treatment is particularly gentle and rather painless. The examination of the urethral stricture and a suitable treatment is carried out by a specialist for urology. [mukocell.com]
Treatment and prognosis Treatment options include urethral dilation, internal urethrotomy, or permanent urethral stenting. [radiopaedia.org]
Prognosis
* Urethral fistula needs surgical repair. 14 Prognosis Urethral stricture should not be considered cured untill after 1 year from the last Rx. * During this period,observation is needed for recurrence. * Follow up by uroflowmetry & uethrogram to assess [slideplayer.com]
[…] and even urinary incontinence A treatment of Urethral Stricture in Women may involve cystoscopy, surgical procedures, such as urethroplasty, and the placement of a catheter (if required) Urethral Stricture in Women can be treated completely and the prognosis [dovemed.com]
In partial epispadias, prognosis for continence with treatment is good. [msdmanuals.com]
These investigations are important in deciding course and prognosis of patient. Few of the important factors associated with success of urethroplasty are the surgeon who is doing the surgery and the place where it is done. [urethraandpenilesurgery.com]
Etiology
The final chapter deals with the etiology, pathology, clinical diagnosis, and treatment of priapism. This book is a valuable resource for physicians. [books.google.com]
Urethral strictures - Etiology Etiology of male urethral strictures The male urethra is a tubular structure about 18 cm in length, and it may present an occlusion or reduction of his caliber that is called urethral stricture. [urethralcenter.it]
Idiopathic It is sometimes not possible to establish the stricture etiology in some patients. These “strictures of unknown etiology” have been related to unrecognized minor trauma occurring in childhood. [uretra.it]
The demographics of the affected population is dictated by the etiology, but in general, it is safe to say that adult males make up the vast majority of cases. The primary mode of presentation of a symptomatic stricture is with poor urinary stream. [radiopaedia.org]
ABSTRACT Pediatric urethral narrowing or idiopathic etiology of a stricture is difficult to suspect in the absence of classic obstructive lower urinary tract symptoms. [urotoday.com]
Epidemiology
The Panel suggests the following issues in future investigations: Both basic science and epidemiological research into the etiology of urethral strictures. [auanet.org]
Pathophysiology
Catheter induced strictures are not uncommon and pathophysiologically resemble trauma induced stricture. Malignant strictures are not common but may be formed in association with urethral and penile tumours. [bioline.org.br]
Prevention
The following measures may be considered to avoid or prevent Urethral Stricture in Women: Practicing safer sex methods, which can help prevent urethral strictures caused by sexually-transmitted diseases Quick and immediate medical attention can help prevent [dovemed.com]
Early treatment of urethral stricture may prevent complications such as kidney or bladder infection or injury. [readycureayurveda.com]
Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. [books.google.com]
Namely, inflammation of urethral tissue may cause scarring, and such scars prevent normal expanding of the organ during urination, hence the problems. [ic.steadyhealth.com]