Urethral stricture (narrowing of the urine tube)Urethral stricture (peshab ki nali ka tang hona)

Urethral stricture kya hai

Urethra woh nali hai jo peshab ko bladder se jism ke bahar le jati hai. Urethral stricture is nali ke andar aisa nishan (scar) hai jo isay tang kar deta hai, is liye peshab aasani se bahar nahi nikalta. Bladder ko zyada zor lagana parta hai, aur waqt ke saath dhaar kamzor ho jati hai aur bladder poori tarah khali nahi hota.

Yeh jaana-pehchana masla hai jo aksar chhoot jata hai ya barhe hue prostate samjha jata hai. Is ka ilaaj ho sakta hai, lekin theek ilaaj ahem hai, kyunke ghalat ilaaj stricture ko lamba aur marammat ke liye mushkil bana sakta hai. Yeh guide batati hai ke yeh kyun hota hai, kaise pakra jata hai, aur ilaaj ke kya intikhabat hain, jin mein yeh bhi shamil hai ke baar baar khinchna aksar kyun jawab nahi.

Kamzor dhaar hamesha prostate ki wajah se nahi hoti. Khaas tor par jawan aur darmiyani umar ke mardon mein stricture aam wajah hai aur us ki jaanch honi chahiye.

Yeh kitna aam hai

Urethral stricture auraton ke muqable mein mardon mein bohat zyada aam hai, kyunke mardana urethra lambi hoti hai. Yeh kisi bhi umar mein ho sakta hai, aur kuch mardon mein ilaaj ke baad wapas aa jata hai. Bohat se mard wajah milne se pehle saalon tak kamzor dhaar ke saath guzarte hain.

Yeh kyun hota hai

Stricture urethra mein nuqsan ya soojan se banne wala nishan hai. Aam wajohat yeh hain:

• Catheter, ya urethra ke zariye koi procedure, jaise operation ya hospital ke qayam mein istemal hone wala catheter, ya pehle urethra ke zariye prostate ya bladder ka operation.
• Chot, jaise kisi sariye par taango ke beech girna ya us hissay par laat, sarak ka hadsa, ya pelvis ka fracture.
• Urethra ka infection ya lambe arse ki soojan, jis mein kuch jinsi taur par muntaqil hone wale infections bhi shamil hain (dekhein peshab ke infection ki guide). Meherbani karke sharminda na hon. Puranay infections se stricture aam hai.
• Penis ki jild ki bimari jis se nok par safed, sakht hissay bante hain (lichen sclerosus).
• Paidaishi farq ki pehle ki marammat jaise hypospadias (dekhein hypospadias guide).
• Urethra mein baar baar zabardasti instruments ka istemal, masalan kisi na-tajarbe-kaar shakhs ka baar baar khinchna.
• Kuch mardon mein koi wajah nahi milti.

Stricture kisi khurak, peshab rokne ya mushti-zani se nahi hota. Meherbani karke apne aap ko qasoorwar na thehrayen.

Aam alamaat

Alamaat aam tor par aahista aati hain aur mahino ya saalon mein barhti hain:

• Kamzor, aahista ya patli peshab ki dhaar, ya aisi dhaar jo do hisson mein baat jaye ya bikhre.
• Peshab karne ke liye zor lagana, ya der lagna.
• Mehsoos hona ke bladder khali nahi hua, ya thori der baad dobara peshab aana.
• Peshab khatam hone ke baad qatray tapakna.
• Baar baar peshab ke infection, peshab karte waqt dard, ya peshab ya semen mein khoon.
• Bilkul peshab na kar paana (dekhein urinary retention guide).

Agar aap ki dhaar kamzor ho gayi hai to meherbani karke yeh na samjhein ke yeh sirf umar ya prostate ki wajah se hai. Urologist ko dikhayein aur poochein ke kya stricture ki jaanch hui hai.

Tashkhees kaise hoti hai

Aap ka doctor aam tor par:

• Aap ki alamaat ke baare mein poochega, pichhle catheters, operations, chot ya infections, aur muaina karega.
• Peshab ka test karega infection ke liye, aur khoon ke test se kidney ki karkardagi dekh sakta hai.
• Peshab ki raftaar naapega (flow test) aur ultrasound se bladder mein kitna peshab reh jata hai.
• Urethra ka dye wala X-ray karega (retrograde urethrogram) taake tang jagah aur us ki lambai maloom ho. Dye nok se aahista dali jati hai aur X-ray tasveerein li jati hain.
• Patle camera se andar dekhega (cystoscopy), taake stricture aur baqi nali nazar aaye.

Stricture ki theek jagah aur lambai jaanna tay karta hai ke kaunsa ilaaj kaam karega. Meherbani karke in tests ke baghair baar baar khinchne par raazi na hon.

Ilaaj ke tareeqay

Theek ilaaj is par mabni hai ke stricture kitna lamba hai, kahan hai, pehle kitni baar ilaaj ho chuka hai, aur aap ki sehat.

Meherbani karke aisa surgeon aur hospital chunein jo strictures ka ilaaj aksar karte hon. Poochein ke kya aap ke liye urethroplasty mumkin hai, aur doosri raaye lene mein hichkichayen nahi.

Baar baar khinchna ilaaj kyun nahi

Stricture ko khinchna ya nishan kaatna aik baar madad kar sakta hai, lekin nishan wala tissue dobara ban jata hai, aksar har baar zyada lamba aur sakht. Bohat se mard har chand mahine ya saal wohi procedure dobara karwate hain, aur waqt, kaam aur sukoon khote hain, aur stricture lamba aur marammat ke liye mushkil ho sakta hai. Yeh khaas tor par tab hota hai jab yeh kisi aise shakhs se karwaya jaye jis ki khaas tarbiyat na ho, ya aisi jagah jahan stricture ki theek naqsha-kashi na hui ho.

Agar khinchne ya telescope procedure ke baad stricture wapas aa jaye to meherbani karke apne urologist se marammat ke operation (urethroplasty) ke baare mein poochein, wohi ilaaj dohrane ke bajaye. Aur meherbani karke theek jaanch ke baghair kisi ko chemist ya chhote clinic mein apni urethra khinchne na dein.

Apni dekh bhaal

Yeh qadam madad karte hain:

• Kaafi paani piyein aur peshab baqaidgi se karein, zor lagaye ya bohat der rokay baghair.
• Peshab ke infection ka jaldi ilaaj karein, aur doctor ko batayein agar baar baar hon.
• Kamzor hoti dhaar ko nazar andaz na karein. Jaldi urologist ko dikhane se zyada intikhabat milte hain.
• Jo doctor catheter ya procedure ka plan kare usay batayein ke aap ko stricture hai ya tha, taake yeh aahistagi se ho.
• Agar aap ko self-catheterisation sikhayi gayi ho to routine bilkul waise hi karein, saaf hathon aur saaf samaan ke saath.

Follow-up

Strictures wapas aa sakte hain, kabhi saalon baad, is liye ilaaj achha hone par bhi follow-up ahem hai. Aap ka urologist aap ki dhaar dekhega aur flow test, bladder ka scan, ya camera jaanch dohra sakta hai. Meherbani karke in visits ko na chhodein, aur jaldi aayein agar dhaar dobara kamzor ho, zor lagana paray, ya infection hon.

Aam sawalaat

What a urethral stricture is

The urethra is the tube that carries urine from the bladder out of the body. A urethral stricture is a scar inside this tube that narrows it, so urine cannot flow out freely. The bladder has to push harder, and over time the stream becomes weak and the bladder may not empty fully.

It is a well-known problem that is often missed or mistaken for an enlarged prostate. It can be treated, but the right treatment matters, because the wrong one can make the stricture longer and harder to repair. This guide explains what causes it, how it is found, and the treatment choices, including why repeated stretching is often not the answer.

A weak stream is not always the prostate. In younger and middle-aged men especially, a stricture is a common cause and should be checked for.

How common it is

Urethral strictures are much more common in men than in women, because the male urethra is long. They can occur at any age, and in some men they come back after treatment. Many men live with a weak stream for years before the cause is found.

Why it happens

A stricture is scar tissue from damage or inflammation in the urethra. Common causes include:

• A catheter, or a procedure through the urethra, such as a catheter used during an operation or a hospital stay, or earlier prostate or bladder surgery done through the urethra.
• Injury, such as a fall astride a bar or a kick to the area between the legs, a road accident, or a pelvic fracture.
• Infection or long-standing inflammation of the urethra, including some infections that can be passed on sexually (see the urine infection guide). Please do not feel judged. Strictures from past infections are common.
• A skin condition of the penis that causes white, hard areas at the tip (lichen sclerosus).
• Past repair of a birth difference such as hypospadias (see the hypospadias guide).
• Repeated forceful instrumentation of the urethra, for example repeated stretching by an unskilled person.
• No cause found, in some men.

A stricture is not caused by anything you ate, by holding urine, or by masturbation. Please do not blame yourself.

Common symptoms

Symptoms usually come on slowly and get worse over months or years:

• A weak, slow or thin urine stream, or a stream that splits or sprays.
• Straining to pass urine, or taking a long time.
• Feeling that the bladder has not emptied, or passing urine again soon after.
• Dribbling after finishing.
• Frequent urine infections, pain when passing urine, or blood in the urine or semen.
• Inability to pass urine at all (see the urinary retention guide).

If your stream has become weak, please do not assume it is just age or the prostate. See a urologist and ask whether a stricture has been checked for.

How it is diagnosed

Your doctor will usually:

• Ask about your symptoms, any past catheters, surgery, injuries or infections, and examine you.
• Test your urine for infection, and may check your kidney function with a blood test.
• Measure how fast you pass urine (a flow test) and how much is left behind in the bladder (a quick ultrasound scan).
• Arrange a dye X-ray of the urethra (a retrograde urethrogram) to show where the narrowing is and how long it is. The dye goes in gently from the tip, and X-ray pictures are taken.
• Look inside with a thin camera (cystoscopy) through the urethra, to see the stricture and the rest of the tube.

Knowing exactly where the stricture is and how long it is decides which treatment will work. Please do not agree to repeated stretching without these checks.

Treatment options

The right treatment depends on how long the stricture is, where it is, how many times it has been treated before, and your health.

Please choose a surgeon and hospital that treat strictures often. Ask whether urethroplasty is an option for you, and do not hesitate to ask for a second opinion.

Why repeated stretching is not a cure

Stretching or cutting the scar can help once, but scar tissue tends to form again, often longer and tighter each time. Many men go back for the same procedure every few months or years, losing time, work and comfort, and the stricture can grow longer and harder to repair. This is especially true when it is done by someone without special training, or in a place where the stricture has not been properly mapped.

If a stricture returns after stretching or a telescope procedure, please ask your urologist about reconstructive surgery (urethroplasty) rather than repeating the same treatment. And please do not allow anyone to stretch your urethra in a chemist or small clinic without a proper check.

Looking after yourself

These steps help:

• Drink enough water and pass urine regularly, without straining or holding on for too long.
• Treat urine infections promptly, and tell your doctor if they keep coming back.
• Do not ignore a weakening stream. Seeing a urologist early gives more treatment choices.
• Tell any doctor who plans a catheter or procedure that you have, or had, a stricture, so that it can be done gently.
• If you were taught self-catheterisation, follow the routine exactly, with clean hands and clean equipment.

Follow-up

Strictures can come back, sometimes after years, so follow-up matters even when treatment has gone well. Your urologist will check your stream and may repeat a flow test, a scan of the bladder, or a camera check. Please do not skip these visits, and come sooner if your stream weakens again, you strain, or you get infections.

Common questions