Saturday, June 26, 2010

Stricture of Urethra Following Prostate Surgery

There are many procedures for surgical treatment of benign prostatic enlargement (BEP); from open surgery to minimal invasive ones. Transurethral ressection of prostate (TURP) is the gold standard procedure at present. It has the advantages of shorter hospital stay and lesser pain than open surgery. Still, it also has the complications like;
  1. Erectile Dysfunction
  2. Incontinence of urine
  3. and
  4. Stricture of urethra
etc. In the recent past we have encountered a few cases of stricture of urethra leading to acute retention of urine. Acute retention of urine is a very painful condition, though does occur suddenly; the warning features are usually ignored. There may be;
  1. Narrowing of the stream of urine for several days in the preceding to retention
  2. Straining during urination to completely evacuate the bladder
  3. Sometimes fever due to superadded infection in the already accumulating urine following incomplete emptying of bladder
  4. and
  5. Sometimes stone formation in the stagnant urine
In case of acute retention of urine, bladder has to be evacuated to give relief to the patient. Metal dilators of small caliber are tried to negotiate the narrowed part and may times succeeds in relieving the condition. But, sometimes a dilator cannot be passed requiring emergency surgery to put a catheter to the urinary bladder through the lower abdomen. The stricture is then evaluated through imaging to assess the segment of stricture. Many cases can be managed by regular dilation of urethra and sometimes a surgical procedure is adopted to correct the urethra.
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