The ever expanding medical field has been obsessed with life threatening, dramatic preventions and cutting edge technology to provide those additional years. For decades, the advancement in medicine meant cardiology, heart and neurology and neurosuregry-the brain. While the advancement was holistic, little was done to explain and create awareness about diseases of Genitourinary system.
This too was dominated by the prostate cancer for a long time. So, why not care to learn a little about one of the oldest diseases of human race the stricture of the urethra. The presence has been described by ancient Roman and Egyptian scripts as after effects of prostitution and sexually transmitted diseases. Although that was not the only cause.
A little peep into anatomy will make you understand that the human urinary bladder lies just above the male or female urinary outlet deep inside human pelvis. It is connected to exterior in females using short tube called urethra which is approximately one and a half inches. The same size in male takes an extended size dimension of upto eight inches and with a male sexual organ the prostate lying just below the Urinary bladder. This makes things complicated for males. The stricture by definition is the narrowing of the urinary pipe or urethra anywhere from the meatus to the bladder outlet. The causes vary from infection which may be sexually transmitted or urinary tract infections to trauma of urinary tract.
The trauma may be local trauma such as fall between legs to pelvic trauma because of road traffic accident or fall from height. The pelvic trauma is a particular distinct injury and is classified and treated as a different entity which is generally a complex issue to treat.
The so called inflammatory of post infectious Urethra; strictures are the ones that involve the penile and the bulbar (essentially the part of urethra behind the scrotum) are real narrowings that need treatment.
Pelvic fracture related trauma or PFUDD as they are called are actually tearing apart of the two ends of the urinary tract and is akin to plucking of apple from the stem , apple being the prostate. It may be associated with Erectile Dysfunction and needs elaborate repair and rehabilitation.
There is no medical treatment for Stricture Urethra and treatment merits surgery.
The disease had been treated with hurculean attempts at blind dilatations or cuts with metal hooks since ages of Sushruta and Egyptian relics. With the middle ages came the more naleeable urethra dilators probably with more knowledge of science, anatomy of human body. The Listerian era brought the hygeine but definitive treatment was still far.
Not till the turn of the last century with advent of X-Rays was diagnosis possible inconsequentially. Also with availability of the light lens arrangements and optical revolution were we actually able to penetrate and see for ourselves how much of the urethra had been narrowed. The same could be treated endoscopically.