A urethral stricture does not come and go. It is a scar causing a
fixed narrowing within the urethra. It is true that patients with
strictures experience variations in flow rate. The ability of the
bladder to contract varies. In addition, flow rate is significantly
related to the radius-cir***ference of the urethra. Most ****tions of
the normal adult male urethra have a cir***ference of over 30mm (this
is measured in french size....30mm cir***ference = 30 french). When
there is a change to 16 french, this is not that noticable. When
patients have a stricture, the caliber is often less than 10 french and
when the urethra is say.... 8 french, just a slight change-variation in
caliber markedly affects flow rate.
It is very easy to tell if a patient has a stricture with a test called
a urethroscopy, a test involving looking in the urethra with a flexible
instrument. At our Center when over 90% of our patients come for
treatment of urethral stricture disease, we do this using a camera and
monitor so that the patient can see his urethra. If a stricture is
seen, then the diagnosis is made and the patient then has imaging
studies to *****s the exact length, location, and severity of the
disease to determine the risks and benefits and expected outcomes of
all treatment options. A stricture is generally obvious to the patient
who often sees a "wide tunnel" abruptly tapering to a pinpoint opening
preventing further passage of the scope.
Although the force of stream is a concern to patients the "big picture"
involving urethral stricture disease is that it does not resolve
without treatment, and strictures cause obstruction of the urine flow.
The problem with untreated obstruction is that it can lead to problems
such as bladder damage (that can be permanent), prostatitis,
infections, and even kidney failure. Although these problems do not
always occur, I have seen all of them. Observation is always an option
for any condition, but not one I would generally recommend for
stricture disease. I hope that helps.
Sincerely,
Joel Gelman, M.D.
Department of Urology
Director, Center for Reconstructive Urology
UCI Medical Center
www.urethralstricture.com
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