Introduction:
Urethral stenosis is defined as a scar that comes either from a traumatic or inflammatory wound in the urethral tissue itself, which in turn leads to circular scarring that narrows the urinary incontinence from 1/2 centimeters to 3 or 4 centimeters. The urethra is a urinary canal surrounded by an esophageal body located between the two bodies of the penis and there are two main parts of this channel are the anterior anterior, which contains three parts (the segment of the sclera, the drop and the port), and posterior, which contains The two parts (membrane part, prostatic part).
Causes of urethral stenosis:
1 - chronic bacterial urethritis, which was not treated by effective antibiotics against the germs that cause this inflammation and correctly and early after the infection, where in the past century the most widespread of Gonococcal Infection and the development of effective antibiotics against this sexually transmitted infection This type of urethral constriction in recent years. 2. Urethral Trauma This occurs after Traumatic Injury or after a visual examination or catheterization. This is caused by a wound during the examination of the diaphragm of the same or after the attempt to insert a catheter in the urethra and injured these two methods are the most common causes of narrowing in the urethra and this leads to narrowing in the injured area, and the most common causes of the narrowing of the posterior membrane of the urethra is The traumatic traumatic wound is either caused by a traffic accident or fall from a top-down area called Fall Astrid Injury, which is ruptured by the membrane segment due to a fracture in the bones of the pelvis, especially the anus bone in the case of traffic accidents or injuring the posterior part of the urethra located behind the area The pubic after Collision of the ground due to falling from high to low and after a period of time on the traffic accident and rupture or break the membrane part of the urethra fill the sides of the urethra and close completely, and in the case of falling from high This emergency also lead to the narrowing of the scar tissue or partial or total interruption For this urethra. As mentioned above, due to road accidents, especially due to fractures in the pelvic bones, especially in the tubal fibrosis area, pubic partial or total rupture occurs in the posterior part of the urethra, especially in the area of the bosomal junction of the bulbous membrane of the urinary tract (Bulbomembranous Junction) , And the cause of narrowing in this area of urethra after these road accidents and fractures in the basin is either full or partial (Avulsion) in the membrane segment of the urethra, especially at the end of the bulbous part (Bulbous Urethra) and the beginning of the membrane Perinial (Perineal Membrane) or because of the phenomenon Called scissor effect The fractured part of the pelvic bone in the urethral region is cut partially or completely in the membrane segment. Therefore, there is no loss of the length of the urethra after these events. However, there is a fibrotic block between the end of the two segments, accompanied by a Distraction or Distortion, With varying degrees of this discontinuous part, and short urethral constriction in this region of the posterior urethra either have a congenital or inflammatory cause.
Symptoms:
This is usually the result of urinary incontinence, and sometimes these patients become infected with the prostate or epididymis due to this constriction, which in turn leads to contaminated urinary reflux. With bacteria to these organs, which are repeated from time to time, but in the case of partial or total rupture of the urethra due to fractures in the bones of the pelvic bone symptoms are the interruption of urination completely and the exit of blood from the urethra rather than urine.
Diagnosis:
1 - Examination of the volume of urethra by ultrasound after the acquisition of colored material in the urethra and is one of the latest diagnostic methods in our time, where it is possible to diagnose the location and length or cystic fibrosis within the urethra instead of diagnosis by x-ray harmful to the testicles radiation, which in turn lead to reproductive reproductive damage For future generations especially if the patient is of married age or married. 2. The video endoscopy of the urethra is complementary to the diagnosis of narrowing. The presence of fibrosis in the spongio fibrosis is clinically determined to follow a special surgical and surgical strategy for this narrowing. Ultrasound and the amount of urine remaining in the bladder after the patient's voluntary urination.
the cure:
The modern treatment strategy is based on the "Reconstructional Ladder Approach", which is based on the method of initiation in the most basic surgical procedures and develops into complex and difficult surgical procedures if necessary. Where it begins to expand the urethra, and then to narrowing the narrowing by telescope or by laser and ends with Reconstructive Surgery) if there is a clinical and satisfactory need for it. At present, modern surgical procedures have been developed to transfer tissue to the narrowing area after surgical removal. This is a strategy in reconstructive surgery. The method of expansion is by catheter, which is the treatment method in patients diagnosed with simple scarring in the synovial membrane surrounding the urethra. For which no surgical or surgical procedure can be performed for other pathological reasons.
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