Pelvic pain may accompany urethral stricture.
Urethral dilation is a medical procedure in which the urethra is gently stretched with a rubber or metal tube. An abnormal narrowing of the urethra, called a stricture, can inhibit the flow of urine and cause serious health problems, making this procedure necessary. While urethral dilation is typically performed by a urologist, with proper training and precautions, it can also be performed by a patient.
Conditions that require treatment
When abnormally narrowed, the urethra may require a medical procedure called urethral dilation.
This procedure is used to treat urethral strictures. They can be caused by scarring from an injury, repeated bacterial infections like urethritis, a history of sexually transmitted diseases (STDs), or trauma from inserting an instrument such as a cystoscope or catheter. Rarely, strictures are also caused by birth defects or tumors. Symptoms of this condition include difficulty or pain when urinating, pelvic pain, and blood in the semen or urine. Patients who are unable to urinate due to an extremely severe stricture should seek medical attention immediately as they may be at risk of bladder or kidney infection or injury as the pool or urine may become infected or abscesses may develop.
A cystoscope can scar the urethra.
Those with frequent urinary tract infections may also require occasional treatments. Having repeated infections can be a sign of an abnormally narrow urethra. Dilation often helps decrease the frequency of these conditions because the bacteria that cause them don’t accumulate as easily in a dilated urinary passage.
Medical professionals usually perform urethral dilation in stages. After the patient is prepared for anesthesia, a smooth metal tube is lubricated and carefully inserted into the urethra. The urologist then repeats the process with larger and larger tubes until he or she determines that the urethra is wide enough to urinate easily. This procedure has a success rate of around 50% for first-time presentations. Some people need annual or semiannual treatments to ensure uniform, pain-free urination.
Individuals who have frequent urinary problems may have an increased risk of developing bladder cancer.
Because urinary dilation is not guaranteed to be successful, can cause discomfort and pain when urinating later, and can cause scarring if done incorrectly, some people seek alternative treatments. One of the most common are muscle relaxers to release the muscles that control urination. If urethral dilation is ineffective due to pre-existing severe scarring, surgery may be necessary.
With proper training, the patient can perform urethral dilation at home with catheters of different sizes. The benefits of doing this include immediate attention to the problem and greater comfort and privacy. The procedure usually involves gently cleaning the genitals with a soapy washcloth or disinfectant and then placing a lubricated catheter into the urethra. Patients should move very slowly and never push or force the catheter. Autodilation can drain the bladder; many patients prefer to do this in the bathroom for this reason.
People who self-dilate should be trained by a medical professional to avoid accidentally tearing the urethra or causing an infection. Doctors may also prescribe a course of antibiotics to reduce the risk of infection. All adverse symptoms that occur during self-treatment should be reported to a physician immediately. This includes pain during dilation, pain when urinating later, or blood in the urine.