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Urethral Stricture

  My sixteen year old son just had a test performed yesterday (dye inserted through
  a catheter and then xrays taken) that showed
  a stricture in the urethra. It is near the bladder. He has had a very decreased flow of urine and several drops of blood after urinating for months. C.T scans of his kidneys showed no problems other than the
  finding that he has a horseshoe kidney. His
  bladder has also been xrayed and seems to be fine. The option we have been given is to remove the portion of the urethra and use skin from another part of his body to join the ends. They are talking drains,catheters,
  fairy long recovery etc. PLEASE tell me there
  is a less invasive way to correct this.
  He had a cystoscope precedure don when he was five because he had a few drops of blood after urinating on occassion. They found some inflamation at that time but it went away without treatment. Could that procedure have
  caused this current situation? If so won't
  all this surgery etc. just cause more strictures? The narrowing of the urethra is very apparent on the xrays.Should we try smething else before surgery?
Dear Lois
Thanks for your questions.
Surgery is the only reliable way to correct significant urethral strictures.  Treatment using dilatation  (an uncontrolled stretching) of  stricture usually leads to further scarring.   Any procedure in which the urethra is instrumented can cause stricture formation as can the inflammation that caused the initial problem.   Perineal trauma (hard landing on a bike seat) can also cause strictures.   Future surgery could  possibly cause further scaring but without surgery, he will face a lifetime of problems with this stricture. Good tissues to use for repair of urethral strictures are buccal mucosa ( the inside of the lip/ cheek) as well as penile skin and foreskin..
More individualized care is available at the Henry Ford Hospital and its suburban campuses by calling  1- 800 653 6568. Dr. Stephen Liroff of our department has a particular interest in such problems and would be glad to provide a second opinion if you desire such. We can also arrange local accommodations through this number if this is your need. Please bring any physicians
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