Three strictures of the male urethra

Urethral stenosis is a common symptom at present. Patients with urethral stenosis usually have increased urine volume, urine retention, and frequent urination and urgency when going to the toilet. Urethral stenosis is divided into many types, such as three-point urethral stenosis. This type is not serious, but it must be treated. First of all, the patient needs to relax his mentality. Mental adjustment during treatment will help recovery from the disease.

Advances in the treatment of urethral stricture

At present, the causes of urethral stenosis in my country are:

1) Although trauma is still the main cause of urethral stenosis, in recent years, with the widespread development of transurethral surgery, urethral stenosis caused by various medical operations (including indwelling catheters) has increased significantly and has become the second largest cause of urethral stenosis.

2) Due to the early and standardized use of antibiotics, urethral stricture caused by gonorrhea is less common than before.

3) The incidence of prostatic stenosis caused by lichen sclerosus, also known as obstructive glans xeroticum (BXO), is increasing. LS is a chronic progressive disease involving the external urethral orifice and prostatic urethra. Its treatment cannot be equated with general urethral stenosis and should be taken seriously.

2. Treatment of anterior urethral stricture

The choice of surgical approach for anterior urethral stricture should take into account the stricture, length, degree, location, cause, previous treatment, and patient preference.

1) Penile urethral stricture can be treated with one-stage or two-stage surgery and oral mucosal urethroplasty is recommended. Penile urethra is generally no longer anastomosed end to end.

2) The surgical method for bulbar urethral stricture is mainly based on the length of the stricture:

A. For urethral strictures less than 2 cm, the stricture segment can be removed and the urethra can be anastomosed end to end.

B. For 2~4CM strictures, urethral dilation and anastomosis can be performed.

C, urethral replacement surgery is performed for strictures >4CM.

4. For extremely long urethral stenosis (>10CM), various mucosal replacements are used to completely reconstruct the urethra or to expand the urethroplasty.

Treatment of posterior urethral stricture:

The key to successful surgery is to completely remove the urethra and its surrounding scars to achieve tension-free anastomosis between the prostatic urethra and the bulbar urethra.

Four pairs of understandings of DVIU surgery

Repeated DVIU can make urethral opening surgery more difficult and increase the failure rate.

Indications: 1) Suitable for patients with urethral stenosis length <1.0CM, bulbomembranous urethra has better effect, pendular urethra has poor effect, and spondylosis has more symptoms. 2) Preoperative real-time ultrasound imaging of the urethra can provide a reference for the depth and range of urethral incision, and patients with urethral stenosis length <1.0CM have better effect. 3) DVIU is generally performed only once, and those who fail should choose open surgery.