Clinical Features :
1. Passage of flakes (desquamated epithelium) in urine.
2. Urethral discharge at early morning.
3. Dysurea
4. Straining
5. prolonged micturition
6. Dribbling occur due urine trickling from dilated urethra above stricture.
7. Frequency of micturition is increased at day and night
8. Possible to palpate the stricture from outside as an induration in the urethral floor.
9. Burning micturition
10. Occasionally haematuria secondary to localized inflammatory changes instrumentation and passage of calculi
11. Retention of urine
12. Incontinence of urine
13. Strangury
14. Decreased stream of micturition.
Effect of Urethral Stricture :
1. On Urethra :
Urethra above the stricture may get dilated or diverticulum may be found due to increased pressure from bladder due to straining.
2. On Bladder :
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Musculature of bladder is hypertrophied
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Trabeculation and divertiulum may be found
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Calculi are prone to form in stagnant pool and residual urine
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Long standing cases bladder atony may occur
3. On Ureter and Kidney :
4. On Sexual Organ :
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Seminal vesiculits
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Prostatitis
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Orchitis
Effect of Straining:
Herniation, haemorrhoids, prolapse etc.
Diagnosis:
A) Routine Investigation
1. Blood for HB, TLC, DLC, ESR, V DRL
2. Urine Routine
3. X ray KUB
4. Urodynamic study / volumetric study.
B) Specific Investigations
1. Kidney function test
2. Urine culture and sensitivity.
3. IVP
4. Retrograde urethrography
5. Cystoscopy
Retrograde Urethrography :
It is helpful to confirm the diagnosis -
1. localize the lesion
2. understand the extent and nature of stricture
3. for comparison between before and after treatment |