Urethral Stricture: Causes, Symptoms, and Treatment Options - Urology

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Urethral stricture is a condition characterized by the narrowing of the urethra, which can lead to various urinary symptoms and complications. Understanding the causes, symptoms, and treatment options is essential for effective management.


Causes of Urethral Stricture
Urethral strictures can arise from several factors, including:
1. Trauma or Injury: This can occur due to accidents, surgical procedures, or even aggressive sexual activity. In your case, the direct friction during intercourse without lubrication may have caused trauma to the urethra, leading to inflammation and narrowing.

2. Infections: Recurrent urinary tract infections (UTIs) or sexually transmitted infections (STIs) can lead to scarring and strictures.

3. Inflammatory Conditions: Conditions like lichen sclerosus or other inflammatory diseases can affect the urethra and lead to strictures.

4. Congenital Conditions: Some individuals may be born with abnormalities that predispose them to urethral strictures.


Symptoms of Urethral Stricture
Common symptoms include:
- Difficulty urinating or a weak urine stream
- Pain during urination
- Frequent urination or urgency
- Blood in urine (hematuria)
- Pain in the lower abdomen or pelvic area
In your situation, the pain you are experiencing, especially when manipulating the area, suggests that there may be some degree of inflammation or injury to the urethra.


Treatment Options
1. Conservative Management: In cases of mild stricture, conservative measures such as topical treatments (like the hydrophilic ointment you were prescribed) may help. However, if there is no improvement after a week, further evaluation is necessary.

2. Dilation: This procedure involves gradually widening the urethra using specialized instruments. It can provide temporary relief but may need to be repeated.

3. Urethrotomy: This surgical procedure involves cutting the stricture to relieve the blockage. It is often performed under local or general anesthesia.

4. Urethral Reconstruction: In cases of severe or recurrent strictures, reconstructive surgery may be necessary to remove the affected segment of the urethra and reconnect the healthy ends.

5. Medication: If there is an underlying infection or inflammation, appropriate antibiotics or anti-inflammatory medications may be prescribed.


Recommendations for Your Situation
Given that you have been experiencing persistent pain and the condition has not improved with topical treatment, it is crucial to seek further medical evaluation. Here are some steps you can take:
- Follow-Up Appointment: Schedule a follow-up appointment with a urologist who specializes in urethral conditions. They can perform a thorough examination and possibly imaging studies to assess the extent of the injury.

- Avoid Irritation: Until you receive further treatment, avoid activities that may irritate the area, such as vigorous sexual activity or excessive manipulation.

- Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen may help manage your pain, but consult with a healthcare provider before taking any new medications.

- Hydration: Drink plenty of fluids to help flush the urinary tract and reduce the risk of infection.

In conclusion, while your initial treatment with a topical ointment was a good start, the persistence of your symptoms indicates that further evaluation and possibly more invasive treatment may be necessary. Seeking care from a urologist will provide you with the best chance for recovery and relief from your symptoms.