Urethral Stricture – How does it develop?

The urethra is an important part of the urogenital tract. It acts as the connection from the bladder to the outside of the body and is vital for the expulsion of urine. Whenever the inner diameter of this slender tube is reduced, it’s no longer possible for urine to flow as it should out of the bladder, causing a danger of backlog and the health consequences which comes with this. Owing to the male anatomy, men tend to suffer from urinary tract constrictions more often than women, and there are equally many more possible causes.

Scar Tissue as a Cause

One frequent cause of urinary tract constriction is scar tissue, which builds up inside the urinary tract and consequently make the smooth passage of urine from the bladder much more difficult. The urinary tract is coated inside with a sensitive membrane and when this gets damaged – either internally or externally – scar tissue may develop. External damage includes injuries of a more mechanical nature, for example accidents or sporting injuries. One common example is slipping from the pedals and falling hard onto the crossbar of the bike, thus injuring the genital area. Even injuries to the pelvic area, for example following a car accident, or injuries to the area between the intestines and penis or vagina may all lead to the development of scar tissue, which causes a constriction or the urinary tract and consequently expelling urine.

There may also be internal causes leading to the development of scar tissue in the urinary tract. One classic cause is often medical inspections or operations in the genital area. The urinary tract is the entry point for endoscopic investigations, whereby a thin, flexible tube with a camera at the end is inserted into the body to conduct a bladder investigation. Even when it comes to more gentle investigations, it’s not possible to completely eliminate the risk of internal damage, also known as micro-injuries. This damage to the mucus lining is often minimal, but can still lead to the development of scar tissue, resulting in a constriction of the urinary tract.

The Classic Cause – Catheter

Following any kind of operation or in the care industry in general, it’s sometimes necessary for patients to be fitted with a long-term or short-term catheter, which helps steer urine from the body.Urinary CatheterAs fine and slender as the artificial piping which leads through the urinary tract to the bladder is, it can still lead to damage of the mucus membrane. This, in turn, causes the development of scar tissue, leading to a constriction of the urinary tract. This is especially the case when an indwelling catheter is fitted, which is often a necessary part of the aftercare and regeneration following an operation. Damage to the mucus membrane can, in this case, occur in two possible ways: In the first case, a long-term catheter puts pressure on the urinary tract, leading to a restricted blood flow to this area. Owing to this restriction, the damaged tissue is not able to sufficiently regenerate and heal.

In the second case, it’s not unusual for catheters to contain latex or similar substances which may inlfuence the phsyiological structure of the tissue.
In order to reduce the risk of damage or potential constriction of the urinary tract resulting from the use of long-term catheters, it’s possible for a suprapubic catheter to be fitted a an alternative. In contrast to the transurethal catheter which goes through the urinary tract, a subpubic catheter sees the urine exiting via a slender tube through the abdominal wall.

Deal with Infections thoroughly

In addition to the more mechanical causes, such as injury or catheters as discussed above, it’s possible for the mucus membrane to be damaged as a result of infections. These infections include the typical infections of the urinary system, also known informally as Trippers, or even the less-common sexually transmitted disease, Gonorrhoe, which is caused by bacteria. When these infections heal, it’s possible for scar tissue to develop, leading to a constriction of the urinary tract. Germs and bacteria in the urogenitaltract really must be dealt with thoroughly for two main reasons – firstly, it’s imperative to stop the passage of dangerous bacteria to the kidneys, as this could be very detrimental. Secondly, it’s important to prevent a scarring of the urinary tract in order to hinder problems in the passage of urine from the body.

Replace Mucus Membrane with Connective Tissue

Regardless of what caused the scar tissue constricting the urinary tract to develope, the process is the same: The structural changes in the areas of the mucus which lines the tract mean that the affected area is either compeletely or partly replaced by scar tissue. This connective tissue is significantly more rigid and harder than the original mucus membrane. Consequently the urinary tract becomes constricted where there is a build up of scar tissue, though the level of constriction is dependent on a number of different factors,including, for example ,the severity of injury, the type of therapy and, of course, the individual body’s ablity to heal.

Inherited and Developed Causes

In addition to the build up of scar tissue, prostate hyperplasia is often a cause of urinary tract constriction in men.Prostate hyperplasia refers to an enlarged prostate, caused by the new development of tissue in this area. Although these changes are benign, it does lead to extra pressure on the urinary tract as a result of reduced space. This, generally, can be identified in the reduced flow of urine. Naturally, tumors can also lead to a constriction of the urinary tract in this way, too. It’s rare for a constriction of the urinary tract and urinary obstructions to develop as a result of abnormalities in the urinary system or sexual organs; issues which a child is born with. One example here is Hypospadia. This refers to a developmental disorder whereby the opening of the urinary tract is actually on the lower side of the penis, and is often accompanied by a reduction in the size of the opening, anomalies to the foreskin or undescended testicles.

The majority of causes for a urinary tract stricture include, however, the acquired restrictions caused by scar tissue, tissue build up or the result of infectious diseases.

Accidents as a cause for urethral stricture

Accidents can also be a cause for urethral stricture. There are several accidents, which are considered to be distinctive for suchlike injuries. There are pelvic fractures, for example, or blunt traumas of the genital areas as well. These so called straddle traumas can be induced by falling off a bike, for instance. In consequence of the damage the urethra can be injured, too, or at worst it could tear. In the event of a minor injury, the subsequent scarring of the tissue can eventually lead to a urethral stricture.

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Congenital malformation as a cause of urethral strictures

In five to ten percent of cases, congenital malformations of the urethra constitute the underlying cause of urethral strictures. Physicians distinguish between different types of malformation and the specific procedures involved in removing the urethral stricture. Urethral valves are sail-like membranes that are located within the urethra and cause it to constrict. Meatal stenosis is the medical term applied to a narrowing of the opening of the urethra. Another of these congenital abnormalities is the aforementioned hypospadias, in which the patient is born with an unusually short urethra. An additional five percent of strictures are caused by a condition known as lichen sclerosus. This inflammatory skin condition involves hardening and…

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