While women have several anatomical features that make it more likely for them to get urinary tract infections, men have their own hurdles to overcome that involve the urinary tract. One of the most common ailments men can face in this area is urethritis, which can be caused by a UTI but, in men, is more commonly a symptom of an STD. Several sexually transmitted diseases can cause urethritis, and in the process, instill a sense of apprehension in the patient when it’s recurrent that it could cause permanent damage, such as urethral stricture. What is stricture, and why is it problematic?
Causes of urethritis
Urethritis is swelling of the urethra, and there are multiple causes for this.
- Bacteria. This is the most common cause. In many cases, bacteria find their way into the urethra from an external source. In men, this is often lack of hygiene in the genital region or sexual intercourse, especially if the man engages in anal sex. The bacteria typically responsible is E. coli, which is present in stool.
- Gonococcus. This is the sexually transmitted infection that causes gonorrhea.
- Chlamydia trachomatis. Again, this is a sexually transmitted infection that leads to chlamydia.
- Herpes simplex (HSV-1 and HSV-2). While less commonly affecting the urethra, this STI can also cause urethritis.
- Trichomonas. This sexually transmitted infestation involves the transfer of a single celled organism during intercourse.
It’s important to identify the cause of urethritis in men, since gonorrhea and chlamydia can both lead to a certain type of infection (epididymitis) that can possibly cause infertility. Even if the only symptom experienced from these STIs is urethritis, diagnosing the underlying condition is essential to maintaining an overall healthy body.
Symptoms of urethritis
Urethritis is most often a sign of, or a precursor to, a UTI. Therefore, symptoms are similar.
- The frequent and urgent need to urinate, often without results
- Difficulty starting to urinate, or short spurts of urination
- Pain, itching, or burning during urination
- Pain during sex
- Discharge from the urethral opening
- Blood in the semen or urine
What is urethral stricture?
In some cases, the symptoms that seem to be related to urethritis and UTIs could mean something more detrimental. Urethral stricture is scarring in the urethra, which restricts the flow of urine from the bladder. This sort of problem can cause further complications as well.
Some of the symptoms of urethral stricture in men include:
- Decreased volume of urine stream
- Difficulty or straining with urinating, which can lead to spraying
- Inability to completely empty the bladder
- Increased frequency and urgency to urinate
- Pain when peeing
Urethral stricture is caused by scar tissue in the urethra, which could be a result of several things:
- Sexually transmitted infections
- Use of a catheter, especially recurrent or continuous
- Trauma or injury to the urethra or the pelvis
- Insertion of an instrument during a medical procedure
- Enlarged prostate, or surgery to remove a gland from the prostate
- Cancer in the urethra or prostate
- Radiation therapy for cancer
Can urethritis cause urethral stricture?
While urethritis is swelling that restricts the ability to urinate properly, it doesn’t typically cause scar tissue to form in the urethra and, therefore, isn’t a cause of urethral stricture. However, the reverse could be true. If a man has urethral stricture, it could be the cause of recurring urethritis and even a UTI.
Because bacteria grow more readily in residual urine that sits in the bladder rather than being expelled, men who are unable to empty the bladder are at a higher risk for a UTI, something that isn’t typically a problem for men. Therefore, the fact that urethral stricture makes it difficult to empty the bladder makes it a cause of urinary tract infections and, by association, urethritis.
STIs as a cause
Men should also note that the same STIs that can lead to urethritis man also cause the scarring that leads to urethral stricture. This is yet another reason to practice safe sex, as well as to get tested regularly for any sexually transmitted diseases. Many of them can be treated before the cause a great deal of damage to the body.
Treatment for urethral stricture
Several treatment methods may be employed for urethral stricture, depending on the patient’s situation. Some of the options available include:
- Catheterization. This will help empty the bladder completely, bypassing the blockage of the scar tissue. This won’t treat the condition but is a first step to determining the best option for the patient.
- Dilation. A tiny wire goes through the urethra into the bladder, and a dilator passes over the wire. The size is gradually increased until the urethral opening is satisfactory.
- Endoscopic urethrotomy. This is a microsurgery in which the scar tissue, or stricture, is removed or vaporized using a laser.
- Urethroplasty. This is a restructuring of at least part of the urethra. In some cases, the section with stricture may be removed, and in others, the tissue around the urethra may also require reconstruction.
- Stent or permanent catheter. This is a permanently inserted tube used to increase the width of the urethra and allow for normal flow of urine.