The urethra: when the path to the outside becomes narrow
The urethra is the last stretch of the urinary tract. If it narrows, one feels it on urination long before one knows the cause. A weakening stream is often dismissed as a sign of aging, whereas not infrequently a treatable narrowing lies behind it.
Urethral narrowing (stricture)
In a urethral stricture, the urethra scars and narrows. Typical are a weakened, fanned-out stream, prolonged urination, the feeling of incomplete emptying, and frequent urgency. Causes are inflammations, injuries, previous catheters or procedures, sometimes a lichen sclerosus; in a proportion of patients the cause remains open.
The treatment is guided by the length, location, and history of the narrowing. A short, first-time stricture can be divided endoscopically (urethrotomy). This procedure is quick but has a high recurrence rate with longer or recurrent narrowings. Therefore, with recurrent or long-segment strictures, the open reconstruction of the urethra (urethroplasty) is the durably more successful procedure, often using the body’s own tissue such as buccal mucosa. We advise you honestly which path has the better prospects in your case, instead of stringing together a repeated incision that only postpones the problem. More on reconstruction you will find in the Reconstructive Urology section.
Inflammation of the urethra (urethritis)
Burning on urination and discharge point to an inflammation of the urethra, frequently caused by sexually transmitted pathogens. We secure the cause by a swab or a urine sample and treat in a targeted manner. Important is the co-treatment of the female or male partner, so that the infection does not travel back and forth.
Malposition of the urethral opening (hypospadias)
In hypospadias, the urethra opens not at the tip but on the underside of the penis. It is usually corrected in childhood. In adults, it concerns the consequences of an earlier operation, a previously untreated mild form, or an accompanying curvature. We examine whether a correction improves function and appearance.
Caruncle and benign changes
At the female urethral opening a caruncle can occur, a benign, sometimes bleeding protrusion, especially after menopause. It is harmless but can be treated well in case of complaints. Suspicious changes we distinguish from it.
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Urokompetenz – The Center for Urology
Klinik für Urologie und Urochirurgie der Clinic Bel Etage
Reichsstraße 59
40217 Düsseldorf