Re: urethral dilation

[HFHS M.D.-JJ]

Posted By HFHS M.D.-JJ on August 04, 1998 at 15:40:05:

In Reply to: urethral dilation posted by karen on July 28, 1998 at 16:50:05:






I have a diagnosis of a severe urethral stricture.  The only treatment for me ( as a woman) is urethral dialation.  My question is WHY does this proceedure cause scar tissue?  How does this happen?  Is it from the instruments used?  Thank you for any information on this subject.  Also, how often can one be dialated like that?  What is the long term affects of this proceedure?
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Dear Karen,
Urethral strictures are extremely rare in females, and the practice of urethral dilation (especially in women) has decreased.  In order to justify urethral dilation, one must first demonstrate that there is a bladder outlet obstruction.  This is determined by a urodynamic study which is performed in the urologists office where a catheter is placed in the bladder, and another one is placed in the rectum.  Bladder pressure and volumes and rectal pressures are recorded as the patients bladder is filled through the catheter and after the patient is asked to urinate, flow is also measured.  If a patient has a high bladder pressure while urinating and also has low urinary flow, then one can diagnose bladder outlet obstruction.  Since women do not have a prostate gland, the most common cause is attributed to a stricture at the bladder neck or urethra.  Looking into the urethra and bladder with a cystoscope would be the next step to determine exactly which area of the urethra is narrowed.
Urethral dilation causes several radial tears in the urethra and as each one heals, each one will contract slightly, resulting in a more narrow lumen once the healing is complete.  Therefore, the structure disease gets worse.  In addition, if ones stricture was initially only 1 centimeter in length (for example), the radial tearing of the normal urethral tissue on either side of the scar (proximal and distal to the stricture) will result in scarring, and the scar/stricture will become a longer one.  Although individual patients cases are different, experience shows that once one gets started on the path of urethral dilations, the frequency of dilations increases per given time, and the duration between dilations decreases.  I hope to have answered your questions adequately, and wish you the best.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Sincerely,
HFHS M.D.-JJ
*Keyword: Urethral stricture, urethral dilation

[marg17]

A related discussion, Urethral Dilation was started.