Symptoms of Urethral Stricture

Dysuria

Dysuria: frequency, pain or burning on urination. The patient may complain of difficulty, burning, and pain when passing urine through the urethra. Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder. The symptoms are alleviated using antispasmodic or pain-relieving drugs. The use of antibiotics is suggested only after a urine culture, as urinary tract infection may be the cause of dysuria.


Voiding difficulty

Voiding difficulty: the urinary stream is poor and the patient strains to void using muscular abdominal nisus to either initiate, maintain or improve the urinary stream. The patient complains that he is able to urinate using only the abdominal muscles as in stool evacuation. Using muscular abdominal nisus the urinary stream is also poor, stop and go and post-voiding dribbling is present. Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder.


Urinary Hesitancy

Urinary hesitancy: difficulty in initiating micturition resulting in delayed onset of voiding. The patient is ready to pass urine but the urinary stream has difficulty starting or starts with only some drops of urine which later become a very thin flow. Pain in suprapubic or retropubic area may be present due to incomplete emptying of the bladder.


Slow urinary stream

Slow urinary stream: urinary stream is slow, weak and does not even reach the water but falls on the patient’s shoes. Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder.


Urinary incontinence

Urinary incontinence: involuntary leakage of urine. The patient is forced to use a large incontinence pad or a small diaper to protect the trousers. Urinary incontinence is classified as stress incontinence, urge incontinence and total urinary incontinence. Stress incontinence occurs under strain (cough, sharp movement, strain to lift a weight, etc.). During urge incontinence, the patient complains of a strong and urgent stimulus to urinate, but is unable to reach the toilet and starts micturition beforehand. Total urinary incontinence is due to surgical damage to the urinary sphincters after prostatic surgery.


Urinary frequency

Urinary frequency: urinating too often. The patient is must urinate every hour or more frequently during the day and/or night (Nocturia). Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder. The symptoms are alleviated using antispasmodic or pain-relieving drugs. The use of antibiotics is suggested only after a urine culture, as urinary tract infection may be the cause of urinary frequency. Urinary frequency may be associated to dysuria.


Post-voiding urine retention

Post-voiding urine retention: after micturition, the bladder is not completely empty. Urinary retention is classified as acute or chronic. When acute urinary retention occurs, the patient is unable to urinate and must go immediately to the hospital. Chronic urinary retention occurs when the patient is unable to completely empty the bladder, which may cause pain in the suprapubic or retropubic area.


Abdominal or bladder pain

Abdominal or bladder pain: pain in the suprapubic or retropubic area, which usually increases with filling of the bladder and may persist after voiding. The abdominal or bladder pain is often associated with urinary tract symptoms or with acute urinary retention.


Genitalia itching

Genitalia itching: irritation or itching in the penile skin or glans or inside the urethra. Genitalia itching is frequently associated with dermatological skin lesions, mainly lichen sclerosus disease. The use of medicinal creams may be useful to alleviate the symptoms, but the patient should consult a dermatologist. If there are no skin lesions, itching along the inside of the penis or on the tip of the glans may be due to infection or urethral stricture.


Urgency

Urgency: a sudden compelling desire to pass urine which is difficult to defer. Urgency is often associated with urge incontinence and the patient complains of a strong and urgent stimulus to urinate, the inability to reach the toilet and starting micturition beforehand.


Straining to void

Straining to void: muscular effort used to initiate, maintain or improve the urinary stream by using abdominal muscles, as in stool evacuation. Using muscular abdominal nisus the urinary stream is also poor, stop and go and post-voiding dribbling is present. Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder.


Nocturia

Nocturia: frequency of urination at night. During the night, the patient wakes up every hour or more frequently to go to the toilet. Also, difficulty in initiating micturition resulting in delayed onset of voiding is experienced. The patient is ready to pass urine but the urinary stream does not easily start or it starts with only a few drops of urine which later become a very thin flow. Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder or chronic urinary retention.


Splitting or spraying of the urinary stream

Splitting or spraying of the urinary stream: the urinary stream is fine and forked. This symptom is typical in patients with meatal or urethral strictures. The patient complains that the urinary stream is irregular, fine and forked and wets his trousers.


Urinary tract fever

Urinary tract fever: related to urinary tract infection. A urinary tract fever is a high fever (> 39°) associated with shivers. The fever starts suddenly and immediately reaches a high temperature making the patient’s teeth chatter from the cold. A urinary tract infection is often associated with acute urinary retention, dysuria, voiding difficulties or abscess and phlegmon.


Periurethral abscess or phlegmon

Periurethral abscess or phlegmon: pus in the scrotal or perineal tissues. A urinary tract infection may be complicated by an abscess or phlegmon. The patient also complains of having a urinary tract fever, voiding difficulties or urine retention. In the penile, scrotal or perineal area a hot round mass, with reddened skin may be palpated. A patient showing these symptoms must immediately go to the hospital.


Intermittent urinary stream

Intermittent urinary stream: the urinary flow and stream stop and start on one or more occasions during micturition. The urinary stream is fine and micturition is possible only using the abdominal muscles, as in stool evacuation. Post-voiding dribbling is also present. Pain in the suprapubic or retropubic area may be present due to incomplete emptying of the bladder or chronic urinary retention.


Post-voiding dribbling

Post-voiding dribbling: at the end of micturition, some drops of urine leak out. The patient urinates without difficulties or particular problems, but at the end of micturition, some drops of urine leak and wet his trousers.


Orchitis – epididymitis

Orchitis – epididymitis: infection and inflammation of the testis and epididymis. Orchitis-epididymitis may arise suddenly and is associated with a high temperature. The fever is often associated with acute urinary retention, dysuria, voiding difficulties or abscess and phlegmon. The patient complains of painful and bulky testis, and reddening of the scrotal skin. Orchitis and epididymitis re normally due to urinary tract infection which arrives to the testis through the deferent. When the orchitis and epididymitisis are associated with a high temperature the patient shoul consult a doctor.