Dr. U. Kiesow is chief resident at urology clinic of the Catholic Marien-Hospital Hamburg – He knows exactly how difficult it is for most people to turn to urologists, independent of the medical condition. Therefore, he pays a lot of attention to a trust-based relationship between doctors and patients. The whole team of the urology department at the Marien-Hospital has received sensitivity training to be more aware of the patients’ needs and to carefully pay attention to the patients’ individual well-being.
Dr. Kiesow is an expert in urology and possesses a brilliant understanding of diseases related to the urethra. For that reason, he is the best person to contact with questions around urethra strictures.
In many cases, the narrowing of the urethra is inherent and is more common with boys, but often urethra strictures can also be acquired. This means that they appear at a later stage in life. Women are rarely affected by acquired urethra strictures. There are two different kinds of strictures that need to be differentiated. On the one hand, there are those strictures that develop due to an enlarged prostate. These strictures develop because the prostate presses on the urethra from the outside. On the other hand, there are those strictures that develop because of internal scarring. At first, these latter strictures are only noticeable because of an unusually weak urine flow and because there is a possible drizzle after voiding. In many cases it is also observable that the urine stream is deformed or even split. In addition, many patients mention that urinating can be rather painful.
The causes are not always easy to identify since scarring of the urethra can occur due to the smallest and often undetected lesions of the mucous membrane. They can appear, for example, as consequences of sports injuries or accidents (a typical example is the fall onto the seat stay). The formation of scar tissue can also be a reaction to an irritation of the mucous membrane caused by a urinary catheter or endoscopy. Less often, scar tissue forms as a consequence of infections. To allow for a definite diagnosis, the urine stream needs to be analyzed for pressure and flow. Additionally, ultra sound will give clarity. It will show if any urine is retained in the bladder after voiding. It can also show if there are any abnormalities on the bladder or the urethra. X-rays and endoscopies of the lower urinary tract are other examinations that are often initiated and reveal more clarity.
The question of the right treatment of urethra strictures is a big problem. In most cases, surgical treatment is recommended – such as an incision of the urethra or urethroplasty. A difficulty with this approach is that he most simple methods have a high probability for relapse, while the more sophisticated methods are extremely dependent on the exact clinical picture of the patient.
Dr. Kiesow knows this difficulty and is therefore one of the first urethra specialists offering an innovative treatment that allows for the patient’s own oral mucosa tissue to be used to cultivate a transplant in the laboratory that eventually replaces the diseased part of the urethra. More information on this innovative and gentle therapy is available for afflicted patients during a personal consultation with Dr. Kiesow at the Marien-Hospital in Hamburg.