The male urethra is a canal running from the bladder to the penis. This canal is the vector of the semen and urine. Its shrinkage is a pathology (the “urethral stricture”) that should be addressed at the earliest in order to avoid complications. In that goal, it is important to know the clinical signs that evoke this diagnosis; they can appear suddenly or gradually worsen. However, all is not necessarily characterize a stenosis can be observed in other diseases including urinary or genital infection, or benign prostatic hyperplasia or if cancer developed at the genital or urinary tract.
In case of occurrence of one or more of these symptoms, referral to a urologist is needed quickly.
Note: The terminology regarding urethral anatomy is defined in the article on this subject.
The narrowing of the urinary tract is a mechanical obstacle to the flow of the flow of urine.
This obstacle is mechanically cause urination difficulties, more or less well compensated and over a period longer or shorter by additional efforts bladder for emptying the tank.
The signs and symptoms of urethral stenosis are related to:
- Obstruction: the dysuria
- Inflammation: these are urinary frequency and urge incontinence
- The infection
- The bleeding from the urinary or genital tract: they are hematuria and hémospermies
Dysuria is a difficult urination.
The jet becomes small, end, without pressure and the end of urination is not clear but marked by numerous drops urination and uncontrolled post. Urination is performed several times with a succession of stops and times and the jet splits into becoming bifurcated or multidirectional ( “watering can”), or spiral.
Typically, the first symptoms that appear in case of stenosis are a slowdown in the speed of micturition, and incomplete urination. These events often require the patient to push and make efforts to urinate.
The slow start of urination and poor bladder emptying do not cause humans the usual sense of relief at the end of urination.
Maximum, urination may become totally impossible: it is the complete urinary retention that requires draining the bladder in emergency.
Urinary frequency is the symptom that reflects the unusually frequent urination.
Perceiving the difficulty with which he urinates, the man will urinate more often to reduce discomfort. The unusually frequent urination becomes, night by causing frequent awakenings that disrupt the quality of sleep and fatigue, and also day.
The urge incontinence
It also happens that the need to urinate becomes more urgent, until, in rare cases, make it virtually incontinent patient.
The imperative need of voiding reduces the patient’s safety time. If he does not find the toilet to relieve this urge bordering on unstoppable urinary leakage.
Urinating, the patient may feel sensations more or less severe burns, especially at the urethral meatus at the tip of the penis.
At a minimum, reflect burns urethral inflammation and possible secondary infection of the urethra.
Incomplete emptying of the bladder tank and stagnation of urine may favor the occurrence of infectious acute symptoms, such as prostatitis or epididymoorchitis that must be quickly treated.
More rarely, it can be accompanied by abscesses or infections in scholarship or perineum.
There may also urethral discharge, generally purulent and usually sexually transmitted (genital infections consequences).
Macroscopic Hematuria is bloody urination.
Sometimes this is that microscopic hematuria do while urine remain clear and bleeding is only detectable by analysis.
Semen, also routed through the urethra, is affected by the stenosis.
This can lead to bloody ejaculations (hémospermies) or a reduction in the emission strength of ejaculation.
Absence of symptoms
In a number of cases, the urethral stricture remains asymptomatic, especially in the early evolution, when the muscle of the bladder has preserved its contractility which allows it to compensate by increased work the obstacle to the emptying of the bladder .
These strictures of the urethra unknown can then be discovered:
– If endoscopies or gestures on the lower urinary tract, including the urethra as the passage of a bladder catheter, which exposed the stenosis;
– The waning of trauma likely to generate, as a traumatic rupture of the urethra or the prior notion of a urinary catheter during a previous surgery.
Few bibliographical elements: