What to do if the male urethra is narrow

Urethral stricture is a disease with a particularly high incidence rate in men, and it is also a disease that will have a relatively adverse effect on the health of the male urinary system. Urethral stricture can be treated through some surgeries. Urethral dilation, intracavitary surgery and open urethroplasty are all relatively effective surgical methods for treating urethral stricture. The following will introduce these three methods in detail.

1. Urethral dilation

Urethral dilation plays a certain role in the treatment of strictures, and has a therapeutic effect on fibrosis that only invades the epithelium or superficial corpus cavernosum. After dilation, the stricture is stretched and massaged, improving local blood circulation, promoting the softening of scar tissue, and facilitating the relief of strictures. For those who are more sensitive or those who undergo urethral dilation for the first time, surface anesthesia can be applied. The thinner the probe is and the sharper the head is, the easier it is to penetrate the urethral wall and form a false passage. If a 16F, 14F or 12F probe cannot be dilated, avoid repeated dilation to avoid artificial urethral damage. At this time, a filament probe is used instead. The filament probe is 4 to 6F thick, soft in texture, and has a metal thread at the tail. It can be connected to a metal or hard plastic urethral probe with a screw at the tip. The specification of the urethral probe at the back is 8 to 24F. The filament probe that enters the bladder guides the thicker urethral probe at the back to dilate. Once this method is successful, an ordinary metal probe is used to perform urethral dilation regularly.

2. Endovascular surgery

Urethral stenosis and atresia is the first choice for the treatment of urethral stenosis. Its main advantages are safety, convenience, repeatability, few complications, short hospitalization time and wide indications. It is suitable for all types of urethral stenosis, especially for those with posterior urethral stenosis or those who have had open surgery and have difficulty in re-opening the surgery. At present, the guide wire is mostly used under oscopy to display and determine the location and direction of the narrow urethral cavity, so as to facilitate the purposeful cutting operation. The incision is usually made at 12, 5, and 7 o'clock in the lithotomy position. During the cutting, water should be flushed appropriately to keep the vision clear. After the operation, an 18F or 20F silicone catheter is placed, and the urethral epithelium covers the incision, indicating that the incision has healed. The length of the catheterization time depends on the condition of the narrow segment.

3. Open urethroplasty

Compared with endoscopic surgery, open posterior urethroplasty has a lower recurrence rate. Open urethroplasty includes end-to-end anastomosis and replacement anastomosis. The former is divided into transperineal and transabdominal-perineal/pubic anastomosis according to different surgical routes, and is recognized as the best open surgery.