Membranous urethra stricture is a condition where the membranous part of the urethra (the tube that carries urine from the bladder out of the body) becomes narrowed. This narrowing can restrict urine flow and lead to a variety of complications.
The membranous urethra is located between the prostate gland and the penis. It is surrounded by muscles that control the flow of urine. Any scarring, inflammation, or injury to this part of the urethra can cause it to narrow, leading to a stricture.
Pathophysiology of Membranous Urethra Stricture
Structure
The urethra is divided into four sections:
- Prostatic Urethra: Passes through the prostate gland.
- Membranous Urethra: Located in the pelvic floor.
- Bulbar Urethra: Located in the penis.
- Penile Urethra: Extends to the urethral opening at the tip of the penis.
The membranous urethra is the shortest part, approximately 1-2 cm long. It is surrounded by the external urethral sphincter, a group of muscles that help control the release of urine.
Blood Supply
The membranous urethra receives blood from the internal pudendal artery, which branches into smaller arteries:
- Bulbourethral artery
- Dorsal artery of the penis
Nerve Supply
Nerve supply to the membranous urethra comes from the pudendal nerve, which controls the external urethral sphincter and helps in voluntary urination control.
Types of Membranous Urethra Stricture
- Congenital: Present at birth due to abnormal development.
- Acquired: Develops later in life due to injury, infection, or surgery.
Causes of Membranous Urethra Stricture
- Trauma to the pelvic area
- Pelvic fractures
- Prolonged catheter use
- Urinary tract infections (UTIs)
- Inflammatory diseases
- Radiation therapy
- Prostate surgery
- Urethral surgery
- Sexually transmitted infections (STIs)
- Tuberculosis of the urinary tract
- Cancer treatments
- Instrumentation during medical procedures
- Repeated urethritis
- Hypospadias repair complications
- Trauma from cycling or horseback riding
- Blunt trauma to the groin
- Lichen sclerosus (skin condition)
- Scar tissue formation
- Balanitis (inflammation of the penis head)
- Genetic factors
Symptoms of Membranous Urethra Stricture
- Difficulty urinating
- Weak urine flow
- Urine dribbling
- Pain during urination
- Frequent urination
- Urinary retention
- Blood in urine
- Cloudy urine
- Pain in the lower abdomen
- Urinary tract infections
- Incomplete bladder emptying
- Pain during ejaculation
- Reduced semen flow
- Pelvic pain
- Foul-smelling urine
- Swelling in the genital area
- Inability to control urination (incontinence)
- Urgency to urinate
- Urine leakage
- Nighttime urination (nocturia)
Diagnostic Tests for Membranous Urethra Stricture
- Physical examination
- Medical history review
- Urinalysis
- Urine culture
- Blood tests
- Ultrasound of the bladder
- Retrograde urethrogram
- Voiding cystourethrogram (VCUG)
- Cystoscopy
- MRI scan
- CT scan
- Uroflowmetry
- Post-void residual test
- Pelvic X-ray
- Pressure flow study
- Urethral swab
- Bladder scan
- Anterograde urethrogram
- Prostate exam
- Biopsy (if cancer is suspected)
Non-Pharmacological Treatments
- Pelvic floor exercises
- Catheterization
- Urethral dilation
- Urethral stenting
- Use of a suprapubic catheter
- Clean intermittent catheterization (CIC)
- Diet modifications
- Hydration management
- Avoiding irritants (caffeine, alcohol)
- Behavioral therapy
- Avoiding straddle injuries
- Sitz baths
- Physical therapy
- Avoiding prolonged sitting
- Bladder training exercises
- Smoking cessation
- Use of protective gear (for cyclists)
- Stress management
- Posture correction
- Use of lubricants
- Avoiding repetitive catheterization
- Use of urinary devices
- Acupuncture
- Yoga for pelvic health
- Breathing exercises
- Pain management techniques
- Regular follow-ups
- Support groups
- Educational programs
- Monitoring for UTIs
Drugs for Membranous Urethra Stricture
- Alpha-blockers (e.g., tamsulosin)
- Antibiotics (for infections)
- Anti-inflammatory drugs
- Painkillers (e.g., ibuprofen)
- Anticholinergics
- Muscle relaxants
- Corticosteroids
- Diuretics
- Antispasmodics
- Local anesthetics
- Antiseptic solutions
- Immune suppressants
- Antifungals (if needed)
- Antiviral medications
- Urinary alkalizers
- Antidepressants (for pain management)
- Hormonal therapies
- Probiotics (for preventing UTIs)
- Multivitamins
- Herbal supplements
Surgical Procedures for Membranous Urethra Stricture
- Urethrotomy
- Urethroplasty
- Stent placement
- Suprapubic catheter insertion
- Endoscopic surgery
- Tissue grafting
- Anastomotic urethroplasty
- Buccal mucosa graft urethroplasty
- Laser surgery
- Perineal urethrostomy
Prevention Tips
- Avoid trauma to the pelvic area
- Practice safe sex
- Stay hydrated
- Manage UTIs promptly
- Avoid repetitive catheter use
- Use protective gear for sports
- Quit smoking
- Maintain a healthy diet
- Regular medical checkups
- Avoid prolonged sitting
When to See a Doctor
You should see a doctor if you experience:
- Difficulty urinating
- Pain during urination
- Blood in urine
- Frequent UTIs
- Urinary retention
- Incontinence
Frequently Asked Questions (FAQs)
- What causes membranous urethra stricture? Trauma, infections, surgeries, or radiation can cause it.
- Is membranous urethra stricture common? It is relatively rare but can happen after injuries or medical procedures.
- Can it be cured? Yes, it can be treated with medications, procedures, or surgery.
- Is surgery necessary? Not always. Mild cases can be managed with non-surgical treatments.
- How long does recovery take? Recovery time varies based on the type of treatment.
- Can it recur? Yes, there is a chance of recurrence, especially if the cause is not addressed.
- Does it affect fertility? In severe cases, it can affect ejaculation, which may impact fertility.
- Is it painful? Pain is common, especially during urination.
- Can it cause kidney problems? If untreated, it can lead to bladder and kidney damage.
- What are the risk factors? Injuries, infections, and medical procedures are common risk factors.
- Can women get it? Urethral strictures are more common in men but can occur in women.
- Are there lifestyle changes that help? Yes, avoiding irritants and doing pelvic exercises can help.
- How is it diagnosed? Through physical exams, imaging tests, and urine tests.
- What are the complications? Urinary retention, infections, and kidney damage are potential complications.
- Is it life-threatening? It can become serious if untreated but is usually manageable with proper care.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
