Urethral Stricture Women

Urethral Stricture Women

Urethral Stricture WomenUrethral strictures are a painful condition which is quite common among men. However, women are not completely immune to it. Even though they are very rare, urethral strictures could still appear among women. Due to their rarity, most women are unable to understand the issue when they suffer from strictures. Read on to get a better understanding of Female Urethral Stricture (FUS) and its treatments.

Urethral Stricture Women Explained

The urethra is a part of the renal system, responsible for dispelling liquid waste from the body. It is in the form of a long tube that connects the bladder to an opening of the body. The structure of the urethra differs between men and women. In men, it opens into the tip of the penis, while in women it opens into the vestibule, located between the labia minora.

Urethral strictures are essentially scars in the urethra, which causes it to become
narrow. These scars could occur due to a variety of factors. Naturally, the
narrowing of the urethra can cause many issues. Urethral strictures disrupt the
normal urinary functions and can cause moderate-to-severe pain.

Occurrence of Urethral Stricture Women

Urethral strictures are considered a male issue primarily. Occurrence in women is quite rare. Of all the women that suffer from any kind of Lower Urinary Tract
Symptoms, less than 8% are caused by Bladder Outlet Obstruction (BOO). Among the patients of BOO, only 4-18% of the cases could be termed as Female Urethral Stricture (FUS). However, note that due to its rarity, there is no fixed definition of FUS (unlike in the case of males).

It must also be mentioned that unlike male urethral strictures, scarring is not the
only cause of strictures in women. Sometimes, the urethra could become narrow
on its own. In such cases, dilations are considered the first line of
treatment.

 Causes of Urethral Stricture Women

Urethral Stricture WomenUnlike urethral stricture in men, where the known causes are well-documented, things are more obscure in case of FUS. Due to the rarity of FUS cases, all the causes of urethral strictures in women is not known yet. Still, the following factors could be a cause behind the condition:

·      Trauma
(the most common cause of urethral stricture in either gender. The trauma could
occur from a physical injury or a previous treatment)

·      Radiation

·      Infection

·      Malignancy
(the presence of malignant tumour in the urethra)

·      Iatrogenic
surgery (refers explicitly to the trauma caused from previous surgery)

It is entirely possible that a woman could suffer from urethral strictures even in
the absence of above causes. This makes diagnosis tricky in case of FUS.

 Symptoms Of Urethral Stricture Women

Despite being so rare among women, Female Urethral Stricture shows stronger symptoms in them compared to men. One could expect the following symptoms when suffering from FUS:

·      Hesitancy in urination and poor flow of urine.

·      Frequent urges to urinate, usually with high urgency.

·      Painful urination (dysuria)

·      Inability to void the bladder despite frequent urination.

·      Urinary tract infection (in many cases, UTI was a direct result of FUS).

As you could see, most symptoms of urethral stricture in women is the same as men.

Urethral Stricture Women Treatment Options

Once urethral stricture is diagnosed in a female, various treatment options are
available. In some early cases, women might opt for urethrotomy – a small
operation where a surgical incision is made in the urethra. Urethrotomy is used
to provide immediate relief in case of a painful stricture, but it is not a
permanent solution.

Urethral dilation is a popular treatment option when dealing with FUS. Here, a catheter (or similar narrow tube-like tool) is inserted in the urethra to expand it. It is primarily used in cases where strictures are caused due to muscular
narrowing of the urethra. However, urethral dilation has less than 50% success
rate. In case the stricture returns after the first round of urethral dilation,
it has been observed that subsequent rounds have little or no effect. In such
cases, it is better to move to more reliable treatment options.

Urethroplasty is considered the most effective and permanent solution for urethral strictures. Considering the high success rate among men, the same treatment is also suggested for women. There are various types of urethroplasty options available for the patient. Vaginal graft and vaginal flap both take skin from around the vagina to reconstruct the urethra. They have good success rates, though the surgery is complicated. There is also a chance that the sexual activity might get impacted due to these treatments.

Buccal mucosal urethroplasty is the most common and most successful variant of the surgery. It takes tissue from the buccal mucosa (inner cheek) for reconstructing the urethra. The cheek tissue is resistant to infections and habitual to a moist environment, making it an ideal choice for the surgery.

Before the surgery, it must be ensured that the strictures in the patient are not
aggravated. In case the patient underwent dilations or urethrotomy previously,
a gap of 2-3 months must exist before the surgery. The surgery itself lasts for
2-3 hours, done under local anaesthesia.

 

Life After Urethral Stricture Women Treatment

After the surgery is over, the patient might be kept under observation for 24 hours.
After that, she is discharged and recommended a rest period of 1-2 weeks. The essential part of the recovery is the dissolution of the sutures on the
urethra. After a month, the patient would have to return to the clinic and
undergo tests (like urine flow and cystoscopy) to check for strictures.
Urethroplasty is found to have high (>90%) success rate among women, so the
strictures would most likely be gone.

Life after the operation is considerably better for women. The symptoms caused due to FUS largely disappear, and the urinary functions return to normal. However, patients are recommended to get a check-up every 3-6 months for the next year or two, as urethral strictures have a tendency to re-appear. Apart from that, life becomes entirely normal for patients.

 

Conclusion

Despite its rarity, urethral stricture could be a severe problem for women. Ladies should be aware of what urethral strictures are and how to deal with them.

 

For further information on Urethral Stricture
Women, Consult with

Dr. Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : +91-9999062316
Email:- info@urethraandpenilesurgery.com
Website: www.urethraandpenilesurgery.com

Address: M-4, Greater Kailash-1, New Delhi-110048, Delhi, India