Disease of or damage to the urethra interferes with the passage of urine.
Injury to the urethra is often the result of severe trauma to the pelvis – for example, in a car accident or as the result of a fall. Trauma can also result from catheter insertion (see CATHETERS) or the insertion of foreign bodies. The signs are inability to pass urine, and blood at the exit of the urethra. The major complication of trauma is the development of a urethral stricture (see below).
is inflammation of the urethra from infection.
The sexually transmitted disease GONORRHOEA affects the urethra, mainly in men, and causes severe inflammation and urethritis. Non-specific urethritis (NSU) is an inflammation of the urethra caused by one of many different micro-organisms including BACTERIA, and CHLAMYDIA.
The classic signs and symptoms are a urethral discharge associated with urethral pain, particularly on micturition (passing urine), and DYSURIA.
This involves taking urethral swabs, culturing the causative organism and treating it with the appropriate antibiotic. The complications of urethritis include stricture formation (see below).
This is an abrupt narrowing of the urethra at one or more places. Strictures can be a result of trauma or infection or a congenital abnormality from birth. Rarely, tumours can cause strictures.
The usual presenting complaint is one of a slow urinary stream. Other symptoms include hesitancy of micturition, variable stream and terminal dribbling. Measurement of the urine flow rate may help in the diagnosis, but often strictures are detected during cystoscopy (see CYSTOSCOPE).
The traditional treatment was the periodic dilation of the strictures with ‘sounds’ – solid metal rods passed into the urethra. However, a more permanent solution is achieved by cutting the stricture with an endoscopic knife (optical urethrotomy). For more complicated long or multiple strictures, an open operation (urethroplasty) is required.