Urethral stricture

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Admitted with acute urinary retention. Failed urethral catheterization despite normal meatus. Suprapubic catheter placed.

Patient Data

Age: 25 years
Gender: Male
Fluoroscopy

Ascending (retrograde) and descending (antegrade) urethrograms performed simultaneously to illustrate the entire urethra.

Normal caliber anterior urethra. Huge caliber change at the junction of the bulbous and membranous urethra (x3) with a dilated posterior urethra (poststenotic dilatation).

Case Discussion

A urethral stricture occurs in males typically following trauma and STI's, and less commonly following instrumentation or congenital abnormalities (in infants due to posterior urethral valves).

The urethra is best illustrated with fluroscopic studies: the ascending and descending urethrogram investigations.

This case illustrates a profound short tight stricture at the bulbous-membranous junction which accounts for the presentation with acute urinary rentention.

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