Treatment

Stenosis or Narrowing of the Urethra

Urethral Stricture Treatments

Urethral stricture is a narrowing of the urethra, the tube through which urine flows from the bladder to the outside, which prevents the patient from emptying the bladder normally and spontaneously because the narrowing of the urethra hinders the flow of urine.

Although the treatment of urethral stricture will depend on each particular case, it requires a medical team specialized in its management to ensure good results. The Spanish Association of Urology, the realization of surgeries with teams with a lot of experience in this type of interventions to be able to solve them without risk.

Catheterization

It consists of inserting a small tube called a catheter into the bladder to drain it. Sometimes it is complemented with antibiotics to treat a hidden infection. Self-catheterization may also be an option in cases of short strictures.

Dilation

It is an outpatient procedure that involves the insertion of a small cannula into the bladder through the urethra. Increasingly larger dilators are passed over the cannula to gradually increase the size of the urethral opening.

Endoscopic urethrotomy

It is usually performed in short strictures (less than 1 cm), unique and without previous treatments. It is a surgical procedure through which a cystoscope (a thin tube-shaped instrument with a light and a lens to observe the inside of the bladder and the urethra) is inserted into the urethra with a series of tools to cut and remove the stricture or vaporize it with a laser. Recovery is usually rapid and leaves minimal scarring, although there is a possibility of recurrence.

Urethroplasty

It is performed in strictures of less than 2 cm. It consists of surgical removal of the affected urethral mucosa and re-suturing the mucosal strands. Recurrence of urethral stricture after urethroplasty is rare.

Urethroplasty with graft or flap interposition

It is important to keep in mind that urethral stricture usually has a poor prognosis due to the enormous predisposition for the stricture to reappear. Therefore, it is very important that the treatment is carried out by a urologist very experienced in urethral problems, so that we maximize the chances of achieving good results.

It is also necessary for the patient to have frequent follow-up examinations for at least one year after treatment. In this way we ensure that the problem does not manifest itself again and that there are no infections.

Drug

One of the latest treatment options for urethral stricture is Optilume®, a minimally invasive procedure that involves dilation of the stricture using a drug-eluting balloon. balloon releasing an antiproliferative antiproliferative drug which prevents cell division and thus the growth of new tissue and the fibrosis that leads to stricture. The drug is absorbed by the urothelium, where it remains for more than 30 days, thus preventing recurrence of the stenosis. This procedure is generally performed under sedation and offers good results, both in terms of durability and efficacy, as well as in the prevention of scar tissue formation that usually appears after urethrotomy via the urethral route.