which type of injury requires early surgical treatment to prevent urethral stenosis?

What is urethral stenosis?

The treatment for urethral trauma depends on where and how bad the injury is. Many cases of anterior urethral injury need to be fixed right away with surgery. Minor of these injuries can be …

What procedures increase the risk of urethral strictures?

Objectives: To compile the main methods of surgical treatment of penile and bulbar urethral stenosis. Methods: We review the most updated bibliography, focusing on authors with large …

What is a urethral injury?

A pelvic fracture can result in posterior urethral stenosis due to an associated urethral injury. This condition can also happen as a result of prior treatments for prostate cancer . Prostate cancer …

What is the prognosis of urethral stricture treatment?

Most often, urethral strictures result from injuries sustained during trauma or a medical procedure. In lesser cases, they may develop due to an enlarged prostate (benign prostatic …

Which type of injury requires immediate surgery?

What is the most common mechanism of injury that causes abdominal trauma?

Which organ is most likely to be injured blunt trauma?

Which injury is associated with asymmetric movement in the lower chest wall Ena?

How do you treat an abdominal injury?

How is abdominal evisceration treated?

What is a visceral injury?

What is a vascular injury?

What causes a visceral wound?

When is surgical intervention required with a chest gunshot wound?

How is chest trauma treated?

What are the types of chest injuries?

Can a straddle fracture cause urethra injury?

Injury to the urethra doesn’t happen very often. But this can result from straddle-type falls or pelvic fractures. Dealing with these problems quickly and properly is critical for the best results.

What is the trauma to the anterior urethra?

Trauma to the anterior urethra is often from straddle injuries. This can occur with a sharp blow to the perineum. This type of trauma can lead to scars in the urethra (" urethral stricture "). These scars can slow or block the flow of urine from the penis. Trauma to the posterior urethra almost always results from a severe injury.

Can a trauma to the urethra cause scar tissue?

In males, posterior urethral trauma may tear the urethra completely away below the prostate. These wounds can form scar tissue that slows or blocks the urine flow. For females, urethral injuries are rare.

Where does the urethra go?

The anterior ("front") urethra goes from the tip of the penis through the perineum. The posterior ("back") urethra is the part deep within the body. In females, the urethra is much shorter: it runs from the bladder to just in front of the vagina. It opens outside the body.

What is the posterior urethra?

The posterior ("back") urethra is the part deep within the body. In females, the urethra is much shorter: it runs from the bladder to just in front of the vagina. It opens outside the body. Normal urine flow is painless and can be controlled. The stream is strong and the urine is clear with no visible blood.

What causes a straddle injury to the anterior urethra?

Trauma to the anterior urethra can be caused by straddle injuries—coming down hard on something between your legs, such as a bicycle seat or crossbar, a fence, or playground equipment.

Can a catheter be passed through the urethra?

Your health care provider may try to pass a tube ("catheter") through your urethra. Not being able to pass a tube into the urethra is the first sign of urethral injury. An x-ray is done after squirting a special dye into the urethra. The dye is used to be seen on an x-ray.

Can you be born with a urethral stenosis?

You can actually be born with posterior urethral stenosis. However, this is rare. More commonly, urethral stenosis is secondary to another medical condition or treatment. A pelvic fracture can result in posterior urethral stenosis due to an associated urethral injury.

Can pelvic fracture cause urethral stenosis?

A pelvic fracture can result in posterior urethral stenosis due to an associated urethral injury. This condition can also happen as a result of prior treatments for prostate cancer.

What are the treatments for stenosis?

There aren’t any medications available to treat this condition. Your treatment options typically include: Dilating the stenosis. Open surgery (urethroplasty). Urethrotomy. If you have open surgery, the affected area of scar tissue can be removed and the healthy ends of the urethra are then stitched (sutured) together.

What is the procedure to cut a stenosis channel?

Urethrotomy. If you have open surgery, the affected area of scar tissue can be removed and the healthy ends of the urethra are then stitched (sutured) together. Urethrotomy involves the use of a scope to cut the stenosis to enlarge the channel with the hope that it will then heal in a more open way.

Can urethral stenosis happen again?

Urethral stenosis can happen again after treatment. You’ll need to have regular follow-up appointments with your healthcare provider to make sure you’re healing correctly and to make sure the condition hasn’t returned . You may need several tests, including appropriate exams and X-rays.

What is the name of the condition where the uppermost part of the urethra narrows, preventing

Posterior Urethral Stenosis. Posterior urethral stenosis is a condition where the uppermost part of the urethra narrows, preventing urine from passing out of your body normally. Symptoms of this condition can include trouble urinating, urinary tract infections, bloody urine and pain in your abdomen. Urology 216.444.5600.

What is the narrowing of the urethra called?

Urethral stenosis (sometimes called urethral stricture) is a narrowing of the urethra. A part of your urinary system, the urethra is the tube that urine passes through to leave the body when you urinate. For men, the uppermost one to two inches of the urethra is the posterior urethra. This includes the opening of the bladder and the part ...

What is a stricture in the urethra?

A urethral stricture is a narrowing of the urethra, the tube through which urine exits the body. The condition occurs due to scarring caused by injury, infection, or inflammation. Most often, urethral strictures result from injuries sustained during trauma or a medical procedure. In lesser cases, they may develop due to an enlarged prostate (benign ...

Why is a metal tube inserted into the urethra?

During this procedure, which is done under general anesthesia, a metal tube is inserted into the urethra in order to stretch the area of the stricture. The surgeon begins with a small tube and gradually introduces tubes of greater size until a wide enough opening has been achieved.

Can you use balloons to dilate the urethra?

Newer techniques may use an inflatable balloon to widen the urethra. Urethral dilation works best for people who have scarring only on the inner surface of the urethra (epithelium), rather than surrounding tissues like the spongy part of the penis (corpus spongiosum). If this method fails, surgery may be required.

What part of the urethra is a stent?

Stents are most successful for shorter strictures that occur inside the part of the urethra that runs through the penis (bulbous urethra). They are also useful for patients who cannot undergo reconstruction of the urethra due to other medical conditions.

Can a urethra be reconnected?

During this procedure, the scarred part of the urethra is removed and then either the healthy part of the urethra is reconnected or the urethra is reconnected using a graft taken from the cheek or other body part.

How long does it take for a stent to be removed?

Over time, the stent becomes part of the inner lining of the urethral wall. Other stents are designed to be removed after a few months.

What are the complications of a urethral stent?

Complications associated with urethral stents include pain during intercourse or while sitting (when the stent is placed in the penis), movement of the stent inside the urethra, infection, leakage of urine, blood in the urine, urgency and frequency of urination, urethral irritation, and pain in the kidney, bladder or groin.

What is a non surgical urethral stricture?

Non-Surgical Treatment. A urethral stricture is a narrowing of the urethra, the tube through which urine leaves the bladder and exits the body. A scar in the urethra from swelling, previous procedures, injury or infection may cause a urethral stricutre and block or slow the flow of urine in the urethra. This often causes difficulty ...

Can a stricture occur in both the anterior and posterior urethra?

A urethral stricture can cause mild to severe issues with urination. These symptoms include the following. 3 . Verywell / JR Bee.

Can a stricture cause urination?

The path to diagnosis of strictures is fairly uniform but the treatment can vary based on where the stricture is located. A urethral stricture can cause mild to severe issues with urination. These symptoms include the following. 3 . Verywell / JR Bee.

What are the different types of urethral strictures?

There are four general types of urethral stricture: Iatrogenic: These are strictures caused by medical treatment of a different condition. Idiopathic : The cause of the stricture is unknown. Inflammatory : An infection or another problem caused inflammation in the urethra.

How long does it take for a urethral stricture to form?

While many strictures take months or years to form, a patient may have normal urination before a trauma and after a trauma may have significant urethral stricture due to injury or the swelling caused by the injury. 5 .

What is the procedure called when you remove a stricture?

Urethroplasty. The urethroplasty, also known as “open surgery,” is the surgical removal of the stricture with the reconstruction of the urethra. While this procedure is more involved and far more complex than other treatments, it is thought to have the best long-term outcomes and lowest rate of reoccurrence. 10 .

What is the surgical removal of the stricture with the reconstruction of the urethra?

The urethroplasty, also known as “open surgery,” is the surgical removal of the stricture with the reconstruction of the urethra. While this procedure is more involved and far more complex than other treatments, it is thought to have the best long-term outcomes and lowest rate of reoccurrence. 10 

What is urethral stricture?

Urethral strictures have been a well-known pathology ever since antiquity. Historically, urethral dilation was the first documented treatment for this pathology. Wooden tubes were used for urethral calibration in ancient Egypt. These primitive urologic “procedures” were initially performed due to the accessibility of the urethra (or at least its penile segment) and to the assumption, often true, that removal of the obstacle at this level may improve symptoms of patients who could not urinate. Beginning in the nineteenth century, an important diversification of these dilators is recorded, such as Philips or Benique type dilators. Benique also proposed a calibration scale for these instruments, one Benique unit being equal to 1/6 mm. Modern optical internal urethrotomy was developed by Helmstein (1964) and, although it was initially received with great enthusiasm, it soon became a subject of controversy regarding long-term results.

Is urethral stricture more common in boys than girls?

Urethral strictures are more common in boys than girls. They are classified as congenital, inflammatory, iatrogenic, or traumatic. 50 Congenital strictures are rare, but urethral hypoplasia can occur. Inflammatory strictures are uncommon in children and are more likely associated with gonococcal or chlamydial urethritis in sexually active adolescents. Inflammatory strictures related to chronic indwelling catheters are rare in the modern era. Iatrogenic strictures are encountered after urethral surgery or instrumentation.

Is urethral stenosis a focal condition?

Instrumentation and catheter passage by medical personnel, trauma, and inflammatory diseases are common causes. Congenital urethral stenosis is rare and generally focal. These stenoses are usually in the bulbar urethra, within the area of embryologic joining of the bulbous urethra arising from genital folds and the posterior membranous urethra arising from the urogenital sinus. If this junction is misaligned or incompletely canalized, a discrete stricture may develop. 122

What is urethral dilation?

Dilation techniques include the use of metal sounds, filiforms and followers, catheters, and high-pressure balloons. Ideally, dilation should be performed in the absence of urinary tract infection or colonization. Immediate complications include the creation of a false passage, bleeding, urethral perforation, rectal injury, and failure to achieve the intended increase in urethral caliber. Early complications include sepsis and urinary retention.

What is BNC in RASP?

Bladder neck contracture (BNC) and urethral strictures are rare complication of RASP occurring in only 0.6% of patients who undergo the procedure. 30 The incidence of BNC was reported to be 7.6% in OSP patients with increased frequency among patients who underwent retropubic simple prostatectomy compared to those subjected to the suprapubic approach. 33 BNC is thought to develop from hematomas, urinary leak, or tension at the anastomosis between the bladder neck mucosa and the distal urethral mucosa. 34 Efforts to prevent the incidence of BNC following RASP have focused on ensuring that a watertight anastomosis is created with mucosal apposition and minimal tension. If BNC does ensue, initial management should involve minimally invasive procedures such as urethral dilation or endoscopic incision. Rarely open reconstruction surgery of the bladder neck is required.

What is a cystoscopy?

Cystourethroscopy (endoscopic visualization of the urethra and bladder) can identify urethral strictures and/or prostatic hyperplasia that may be causing bladder outlet obstruction. If other imaging studies are equivocal or patients are unable to receive intravenous contrast administered (due to severe chronic kidney disease (CKD) or allergy), a retrograde pyelography (injection of contrast up the ureters during cystoscopy) may be necessary. Retrograde pyelography provides excellent delineation of filling defects within the ureter, renal pelvis, or renal calyces. Collection of urinary cytology is possible during retrograde pyelography. Cystoscopy also allows for intervention to relieve ureteral obstruction in the same setting, such as placement of a ureteral stent. If a ureteral stent is unable to bypass a ureteral obstruction or does not provide adequate drainage of the kidney collecting system, a percutaneous nephrostomy tube may be necessary to optimize kidney decompression.