One of the primary disorders of the male urethra is urethral strictures that occur when a part of the urethra becomes abnormally narrowed. Since the basic role of the urethra is to guide urine from the bladder and out of the body, this condition results in difficulties while urinating. It is this strain while seeking to empty the bladder that mainly necessitates most men to seek professional attention. The go-to professional for such concerns is always the urologist, as this is their area of specialty. Primarily, these professionals will first perform a test to diagnose the disease before taking any other step. This entails undergoing a cystoscopy to confirm the diagnosis, and this is then followed by X-ray imaging. X-ray imaging is used in determining where the stricture is, its exact length, and how severe it has become.
Once the urologist has all this information at hand, the next step is to determine the right urethral stricture treatment option. Overly, the best treatment for this medical condition is always dependent on the factors at hand that must be the primary focus. This must then be enhanced by the collaborative effort between the urologist and patient to settle on the most favorable treatment technique. The role of the urologists is to provide guidance while the patient has the mandate of weighing the options presented to him. For many men, the concern is always on the best treatment that will help to avoid the recurrence of urethral stricture. Often these cases of recurrence are caused by;
1. Failed urethroplasty
Urethroplasty surgery is an open surgery where an incision is made on the skin before urologists perform direct urethral stricture repair. This is a demanding procedure that must strictly be handled by seasoned urologists and not any other doctor without exclusive specialization in the surgical procedure. Unfortunately, many patients rush to have any doctor perform this procedure in them, resulting in poor outcomes. It becomes worse considering that the recurrence of urethral strictures after these failed surgeries is always more complicated than before.
2. Failed dilations or internal urethrotomy
Men with bulbar urethral strictures tend to have failed dilation and internal incisions. These treatment procedures are unlike urethroplasty as they do not require any incision of the external skin. For recurrences that happen after failed dilations or internal urethrotomy, the best solution is to opt for urethroplasty. To avoid any further risks, these operations must be handled by seasoned specialists to have the benefits of high success rates of between 95 to 99%.
3. Complex urethral strictures
At times all that is required for men who have had more than one failed urethral strictures surgeries is an innovative urethral reconstruction surgery. This is often a necessity in instances when the urethral strictures are long, and there is a need to add tissues to the urethra. The tissues can be added either as a path or along the entire circumference in cases of total obliteration.
What treatment procedure do seasoned urologists recommend?
There is no single surgical procedure to manage all cases of urethral strictures, and the right treatment can only be determined after careful diagnosis of your condition. Any urologists that instantly suggest a specific treatment procedure is often misguided and not a specialist to trust. At a time when there is advanced X-ray imaging known as retrograde urethrogram, there is never a need to guess the right treatment procedure. Instead, urologists must rely on the results from these tests to provide suitable treatment options to the patient.
The core reason why urethral stricture treatment options must be tailored to the condition of the patient is the numerous ways it occurs in men. This is because, while some males have short strictures near the tip of the penis, others have longer strictures located near the bladder. As such, it is only by getting to know the location and length of the stricture that the right treatment procedure can be determined. An example is a urethrotomy that can be suitable for the treatment of strictures that are less than 1.5 cm in length but is not efficient for long strictures. On the other hand, open urethral reconstruction is suitable for recurrent strictures and initial stricture management. Most importantly, is that regardless of the treatment option that is found to be appropriate, patients must have these procedures managed by highly skilled urologists.