Urethral stricture

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain

Presentation

Weak urinary stream.

Patient Data

Age: 25 years
Gender: Male
Fluoroscopy

Significant resistance during retrograde injection of contrast material. A relatively short segment of irregular tight urethral stricture is seen at the distal part of the membranous urethra, measuring about 10 mm in length. Subsequent mild to moderate proximal dilatation of the proximal urethra on the ascending urethrogram. On the antegrade urethrogram, significant dilatation of the prostatic and proximal part of membranous urethra proximal to the site of stricture was formerly described. Some faint contrast smearing and extravasation are seen related to the strictured segment, suggesting possible urethral rupture. The remaining parts of the urethra are intact. The urinary bladder is partially opacified and shows bilateral lateral wall small diverticular out-pouchings, a sequel of long-standing bladder outlet obstruction. Difficult micturition was observed, with only dribbling of the contrast. No definite vesicoureteric reflux detected.

Case Discussion

Left untreated, urethral stricture may cause the following complications: recurrent urinary tract infection (UTI), acute urinary retention, urinary bladder diverticulae and vesicoureteric reflux.

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