Urethral Strictures

Excerpt

A urethral stricture is a narrowing of the urethra, causing obstructive symptoms. These strictures usually result from injury to the urethral mucosa and tissues around it. It is a common condition resulting in many office appointments, emergency room visits, and hospital admissions. Urethral strictures can occur in both sexes but are rare in women, so guidelines are lacking with regard to diagnosing and treating female strictures.

In males, strictures can develop anywhere along the length of the urethra but are most often found in the bulbar urethra and can be due to many etiologies. The male urethra is divided into anterior (from the external urethral meatus to the distal membranous urethra) and posterior (from the distal membranous urethra to the bladder neck) portions. The urethra is contained within the corpus spongiosum, which lies in a groove below the two corpora cavernosa. The inside of the urethra is lined with stratified squamous epithelium. Anterior strictures comprise 92.2%, with most occurring in the bulbar urethra (46.9%), followed by the penile urethra (30.5%), a combination of the bulbar and penile urethras (9.9%), and finally, panurethral strictures (4.9%).

The 2002 World Health Organization Conference recommended a more specific descriptive nomenclature in which the urethra is broken up into 7 segments; the urethral meatus, followed by the fossa navicularis, penile (or pendulous), bulbar, membranous, and prostatic urethra, and lastly, the bladder neck.