The male urethra is a tubular structure about 18 cm in length, and it may present an occlusion or reduction of his caliber that is called urethral stricture. Male urethral stricture may be due to congenital abnormality or acquired diseases. Urethral stricture disease is as old as mankind. In the old times urethral strictures were mainly associated with longstanding infectious disease (gonococcal urethritis) or trauma. Current stricture aetiology in the developed world is mainly iatrogenic, such as strictures after (traumatic) urethral catheterization or transurethral resection, and idiopathic. Besides the aetiology of strictures, also the armamentarium to treat them has evolved. Repeated dilatation or, in complicated cases, external urethrotomy or cystotomy were the only treatment options for centuries instead of leaving the disease on its natural evolution. Today, optic urethrotomy, anastomotic urethroplasty and substitution urethroplasty offer better functional results, better cosmesis and in the majority of patients a permanent solution to the disease.
Stricture urethra is a neglected and poorly managed surgical condition in most part of the world with most of the patients either not relived of symptoms or end up in complications (renal failure, sepsis, hypo contractile bladder etc.) leading from stricture urethra.
Stricture urethra is a treatable condition and a person having stricture urethra should know that before going for the treatment he should be properly evaluated with blood investigations, urine examination and imaging studies to know the exact length and site of stricture. These investigations are important in deciding course and prognosis of patient.
Few of the important factors associated with success of urethroplasty are the surgeon who is doing the surgery and the place where it is done. Reconstructive urology is a dedicated subspecialty and a surgeon who is doing these surgeries routinely can give good results in complex and failed cases.
Stricture urethra patient should also understand which treatment modality is best for him and can provide long-term relief from symptoms.
Major problem with stricture urethra patient is that they are not managed properly in the initial phase. They undergo multiple failed urethrotomies and dilatations leading to scarred urethra and long complex stricture. The success rate of stricture correction depends on number of previous interventions.