Any treatment would aim at seeing that flow of urination is not impeded by the narrowing at the neck of the bladder or later, ease symptoms and to prevent possible complications.

In allopathy, there is no drug or medicinal treatment currently available for this disease.

A long course of antibiotics may be advised to prevent urine infections until a stricture has been widened.

If there is acute retention of urine, a urologist (a urologist treats problems of the urinary tract - such as prostate, bladder, kidney and penis problems) would help in draining with a catheter or a temporary incision through the abdomen. But on certain occasions there is a dilation of the urethra done under anaesthesia by inserting a thin instrument.

Instrumental treatment

Dilatation (widening) of the stricture : This is the traditional treatment. It is a relatively easy procedure to do and so usually tried first. It is usually done by passing a thin plastic rod (bogie) into the urethra. Rods of increasing thickness are gently inserted to gradually widen the narrowed stricture. The aim is to stretch the stricture without causing additional scarring. However, a stricture often tends to gradually narrow again after each dilation. Therefore, a repeat dilation is commonly needed every so often when symptoms recur.

Operative treatment : A corrective operation may be an option if the above does not work

• Internal urethrotomy : In this procedure a thin telescope is passed into the urethra to see exactly where the stricture is. A tiny knife is then passed down the telescope to cut along the stricture. This widens the narrowed stricture. Most people get some relief of symptoms from this procedure and about one-forth are cured for good. However, like dilatation, the stricture may reform and the procedure may have to be repeated from time to time in many cases.
• Urethroplasty and permanent urethral stents : A stent is like a wire mesh tube which gives support to the urethra and helps to keep the urethra widened. For people with severe strictures who choose not to undergo open surgery, permanent catheters or stents can be inserted into the urethra. Urinary catheters need to stay in place for a period of time after many procedures. These can cause infection, bladder irritation and discomfort.

What happens after the above treatments for urethral strictures

Strictures are prone to return after dilation with catheters or endoscopic removal. But since the procedure on repetition has been known to cause worsening of the situation the problem needs to be addressed.

Open surgery to repair the stricture carries the risks of bleeding, infection, and damage to penis or other pelvic structures.

How is stricture urethra monitored

A person treated for urethral strictures should have follow-ups for at least one year. This is to watch for recurrence of the stricture. The primary monitoring test used is uroflowmetry, a test which measures the rate of urine flow during urination.

Can homeopathy help in stricture urethra

Usually patients come to see a homeopathy doctor as a last resort when they have tried almost everything. Surgery is the last option left with allopathy doctors and even after undergoing surgeries the patient is still suffering with distressful symptoms. This is when he looks for something beyond surgery, alternative therapies and cure.

Fortunately, homeopathy is available as one of the best treatments which is the most potent alternative to surgery.

Homeopathy is a type of natural medicine. This system of medicine has slowly risen in popularity over the years, making it now the second most common form of medicine used in the world. Homeopathy offers you a promising life long cure and you do not have to continue medicines for your whole life.

A homeopathic doctor's approach is different from those who practice conventional or allopathic medicine. Homeopathy perceives all symptoms as a manifestation of the body's struggle to self heal. Homeopathic doctors normally do not prescibe medication for individual symptoms.

Given the individualistic and customized approach, different treatments are given to individuals for the same disease based on their characterisitic traits, personality and condition. A person's complete symptomatology will be treated all together. Also, once gone, these symptoms should never arise again.

Homeopathy is safe and natural with no side effects and act from within and make surgical procedure for stricture urethra unnecessary and avoidable.

What are the outcomes of homeopathic treatment for stricture urethera

• Urinary output at every voiding improves; not like the way you experience after dilatation and urethral stents.
• Homeopathy would address the issue when injury or catheterization is known to cause narrowing of urethra by healing the damaged lining of urethra without scarring.
• Homeopathic treatment helps in controlling the urinary infection and checks out the gonorrheal infection (sexually transmitted disease).
• Homeopathy helps in toning the musculature of the bladder wall.
• Homeopathy will prolong the duration between dilatations and will resolve scarring.
• Homeopathy roots out the cause of the problem which is responsible for the distressful symptoms be it scar, injury, infection, suppressed gonorrhoea, enlarged prostate, kidney stones and so on.
• Homeoapthic remedies are also helpful post operatively.
• Homeopathic medicines modifies the disease process and stops the progress of the disease to dreaded complications.

When can the homeopathic remedies commenced in stricture urethra

Homeopathy can be started at any point of time but earlier the person comes, the speedier he recovers and prevents further complications.

What are the chances of curing stricture urethra permanently

The success rate of recovery is more than 95% with homeopathy but may vary from person to person depending upon the age, condition of the patient, status of the problem, treatments already taken and so on.

There are 75 homoeopathy remedies which give great relief in stricture urethra. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the homeopathic doctor. The treatment is decided after thorough case taking of the patient. Thus homeopathic medicines of stricture urethra are designer made unlike allopathy in which all patients receive the same surgery or drugs although trade name may be different.

For online homeopathic treatment of stricture urethra, you may e-mail us on dr_ramanand@rediffmail.com

An elderly gentleman complaining of an unmitigated urgency for urination is usually suffering from an enlargement of the prostate gland but if the stream of urination is not free in somebody younger it could likely be due to the narrowing of the urethra.

Urethra is a fine tube through which urine flows out from the bladder and passes through the penis in men. The urethra is much shorter in women and ends just above the vagina.

In men, semen is also ejaculated through the urethra. The elastic tube (urethra) remains patent and is under the control at the neck of the bladder.

Due to some reasons there is a narrowing of urethra and urine does not pass out thoroughly and this condition is called as stricture urethra.

There is an urge to pass urine but the person finds that he has to wait for the stream to flow out.

More often than not, men find that they take longer time at the restroom to clear their bladder. As it goes, there is a feeling they have to exert pressure voluntarily at urination. At the end of urination there could dribbling of drops and still a feeling that the bladder has not evacuated completely and the urge to attend the toilet after a while again.

The strain of urination could sometimes bring on a burning sensation while and at the end of urination.

There is ensuing infection of the bladder as the urine retained in the bladder is prone to grow bacteria and the wall of the bladder too thickens and it is a vicious cycle. Here given is a checklist for you to notice if you are having any of these :

• Reduced urine flow.
• Dysuria (painful urination).
• Difficulty urination.
• Slow urine stream (may develop suddenly or gradually).
• Spraying of urine stream.
• Decreased urine output.
• Increased urinary frequency or urgency.
• Incontinence, dribbling.
• Blood in the semen.
• Pelvic pain.
• Lower abdominal pain.
• Bloody or dark urine.
• Discharge from urethra at early morning.
• Swelling of the penis.
• Urinary retention.
• Burning during urination.

Stricture urethra happens due to the urethra which becomes narrowed down due to certain causes. The commonest of which happens to be due to :

• An injury either while riding or a fall and not uncommonly after a medical examination of the bladder through the urethra, or radiotherapy treatment which may damage the lining and the healed area could form into a scar narrowing the lumen.
• Infection of the urethra is another cause. For example, sexually transmitted infections such as gonorrhoea or chlamydia. The infection is usually acquired through sexual contact.
• Infection as a complication of longterm use of a catheter to drain the bladder.
• Infection may cause inflammation in the tissues in and around the urethra. These infections usually clear with treatment but may leave some scar tissue at the site of the inflammation which can cause a stricture. A stricture is just one possible complication from a urethral infection.
• Congenital : Some babies are born with a urethral stricture. It is not usually noticeable until late in life, as it fails to widen as the urethra does with growth, thus it only impedes urinary flow relative to the rest of the urethra after puberty. Moreover, the patient will often not "know any difference," and so will not complain about poor flow.
• In infants and toddlers, stricture urethra can be as a result of inflammation following a circumcision and not noticeable until toilet training when a deflected stream is observed or when the child must strain to produce a urinary stream.
• Passage of kidney stones through the urethra can be painful and subsequently lead to urethral strictures.
• Cancer which spreads from prostate cancer or bladder cancer is a rare cause.

Effect of straining : Herniation, piles, prolapse and so on.

More pressure is needed from the bladder muscle to pass urine out through a stricture (it acts like bottleneck). Not all urine in the bladder may be passed when you go to the toilet. Some urine may pool in the bladder. This 'residual' pool of urine is more likely to become infected. This makes you more prone to bladder, prostate and kidney infections.

An abscess (ball of infection) above the stricture may also develop. This can cause further damage to the urethra and tissues below the bladder.

Cancer of urethra is a rare complication of a longstanding case of stricture urethra.

A physical examination may reveal the following :

• Decreased urinary stream.
• Enlarged or tender lymph nodes in the groin.
• Redness or swelling of the penis.
• Urethral discharge.
• Enlarged or tender prostate.
• Distended bladder.
• Hardness on the undersurface of the penis.

The first diagnosis of strictures is made when the healthcare provider is unable to pass a catheter through the urethra. Strictures may also be suspected based on the person's symptoms and medical history. Sometimes the examination reveals no abnormalities then further tests are done :

Tests include the following :

• Urinary flow rate may be measured.
• Post-void residual (PVR) measurement.
• Urinalysis.
• Urine culture (if evidence of infection).
• Tests for chlamydia and gonorrhea.
• Cystoscopy to confirm diagnosis.
• A retrograde urethrogram to confirm diagnosis.