Urethral stricture

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[edit] Discussion of Urethral stricture

  • In general, the term urethral stricture refers to a fibrous scarring of the anterior urethra caused by collagen and fibroblast proliferation.
  • The causes of anterior urethral strictures may be inflammatory (eg, infectious urethritis, balanitis xerotica obliterans), traumatic (straddle injury, iatrogenic instrumentation) or congenital.
  • Most urethral strictures are the result of infection, instrumentation, or other iatrogenic causes.
  • The most common external cause of traumatic stricture is straddle injury.
  • Inflammatory strictures associated with gonococcal urethritis have become less common despite the fact that gonococcus remains the most common sexually transmitted disease.
  • Iatrogenic trauma to the urethra may result from pressure necrosis at fixed points in the urethra from indwelling catheters.
  • Instrumentation-related strictures usually occur in the bulbomembranous region and, less commonly, at the penoscrotal junction.

  • Alternatively, posterior urethral stricture is often an obliterative process that occurs as a result of urethral distraction or disruption caused by either trauma or surgery.
  • Posttraumatic posterior urethral stricture is often associated with resultant displacement of the urethral axis, which results in obliteration from intervening fibrosis.
  • Iatrogenic stricture of the prostatic posterior urethra usually occurs after transurethral resection of the prostate or open radical prostatectomy.

[edit] Imaging Findings for Urethral stricture

  • Retrograde urethrography is the primary method used to image anterior urethral stricture.
  • Radiographic evaluation helps define the location, length, number, and degree of strictures.
  • Sonourethrography is best used adjunctively to guide treatment planning in patients with known bulbous urethral strictures and has been reported to be more accurate than retrograde urethrography for estimating the length of urethral strictures.

  • In posterior urethral strictures following blunt trauma, simultaneous antegrade cystourethrography and retrograde urethrography are often required to determine the length of the urethral defect.
  • MR imaging is considered to be the best ancillary imaging modality for assessing posttraumatic pelvic anatomy.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

Goldminer: Urethral stricture

[edit] References for Urethral stricture