WHAT IS URETHRA ?

Urethra is a tubular channel which transmits the deposited urine to outside of the body and it has a length of 18 to 20 cm in men and 3 to 4 cm in women. Differently from women, semen and prostate gland secretions are also discharged via this tract.

DISEASES OF THE MALE URETHRA

  • STRICTURE (URETHRA AND MEA STRICTURE)
  • BENIGN TUMORS (POLYP)
  • INFLAMMATIONS (URETHRITIS)
  • WARTS (CONDYLOMAS – HPV VIRUSES)

URETHRAL STRICTURE

As male urethra is longer than femal urethra, it is more frequent. The reason for stenosis in women is hormonal while cause in men may be congenital or acquired. The main reason for acquired stricture may be sexually transmitted infections which have not been treated regularly or traffic accidents in young men while this may be a catheter which has not been placed regularly, difficult prostate surgeries of after cystoscopic interventions.

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SYMPTOMS

  • WEAKENING ON URINE FLOW
  • THIN URINE
  • SENSE OF NOT DISCHARGING COMPLETELY
  • Painful urination; bifurcated urination; dripping while finishing the urination

DIAGNOSIS

The following should be applied to the patient who refers to aphysician with these complaints;
Urine test and culture
Urinary system sonography

UROFLOWMETRY

(uretrography: Imaging the ureter by administrating a stained substance into it)
Urodynamic tests

The most practical application that will forward to the diagnosis is UROFLOWMETRIC test.

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UROFLOWMETRY Is a test indicating the rate, form and quantity of the urine flow during urination.

It is used to search disrupted urination function as a result of urinary bladder originated causes or diseases after the urinary bladder exit (prostate hypertrophy, urethra narrownesses). It may be used solely or with cystometry. With this test Graphics of parameters and mathematical values such as Maximum Flow Rate , Mean Flow Rate, Voiding time, Time-to- max, Voided Volume.

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TREATMENT

PURPOSE: As a result of difficult urination created by a narrowed urinary tract, the urinary bladder which should be discharged after the urination becomes tired slowly and starts to remain within the urinary bladder after urination. Kidneys also start to be disrupted after a while and the patient needs DIALYSIS when it disrupts renal functions. The purpose is to repair the narrowness of the urinary tract of the patient before functional failure of the kidney.
URETHRA STRICTURE IS NOT RECOVERED BY DRUGS!!!

Treatment should be planned according to the cause, place, length, period and patient age.

– Enlargement with a plug (dilatation) [soft or metal catheters may be used]
– Baloon dilatation (applied via a cystoscopy)
– Internal urethrotomy (to cut the narrowness by using endoscopic systems)
a. Blind cut (otis urethrotomy)
b. Cut with cold knife visually (sachse urethrotomy)
c. Hot cut via plasma kinetic energy
d. Hot cut with holmium laser

 

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Urethral stent application (placement of metal spiral beads into the urethra permanently or temporarily in repetitive and severe cases)

Open surgeries: This may be necessary for narrowness repeated very frequently and developed after a traffic accident.

The most frequently applied method is urethrotomy intern techniques. After these therapies performed with fully closed endoscopic system, a catheter is certainly placed into the urethra and the patient urinates via the catheter between 1 and 3 weeks. Then, the catheter is removed and the patient should come for plug dilatation within certain periods.

Although urethra stricture are treated well, they tend to repeat frequently. Therefore patients should not hinder regular treatment and monitoring treatments.

URETHRAL POLYPS

These are benign tumors of the urethra. They are masses appearing as grape bunches and protruding from outer orifice of the urinary tract. Diagnosis is easy. The patient refers with a mass on the outer urethra orifice, painful urination or bloody urination complaints. Treatment must be removal of this mass surgically and sending it top the pathology department. All parts of the urinary tract should be observed (cystoscopy) to detect whether there is a polyp in another areas of the urethra for a regular treatment.

URETHRAL CONDYLOMA (HPV)

As urethral warts are visible, diagnosis is easy. They cause same complaints like polyps. Treatments are also same as urethral polyps.