From the Guidelines
Yes, a urethral stricture can completely close off the bladder in severe cases, leading to complete urinary retention, a condition that requires immediate medical attention. This condition is characterized by a narrowing of the urethra due to scar tissue formation, which can progressively worsen until urine cannot pass through at all, as noted in the American Urological Association guideline 1. The presentation of urethral stricture can include decreased urinary stream, incomplete bladder emptying, urinary tract infection, and rising post-void residual urine volume, among other symptoms 1.
Diagnosis and Treatment
The diagnosis of urethral stricture involves a combination of patient-reported measures, uroflowmetry, and ultrasound post-void residual assessment, with definitive diagnosis typically made through urethro-cystoscopy, retrograde urethrography (RUG), voiding cystourethrography (VCUG), or ultrasound urethrography 1. Treatment options range from urethral dilation or internal urethrotomy for minor strictures to urethroplasty (surgical reconstruction) for more complex cases, with the choice of treatment depending on the stricture's location, length, and severity, as well as the patient's overall health and preferences 1.
Complications and Management
Without prompt treatment, complete obstruction can lead to serious complications, including kidney damage from back pressure, urinary tract infections, and bladder dysfunction, highlighting the importance of early diagnosis and intervention 1. In cases where urethral stricture is identified at the time of catheter placement for another surgical procedure, urethral dilation or internal urethrotomy may be performed to prevent complications, or a suprapubic cystostomy may be placed to provide urinary drainage 1.
Recent Guidelines
The most recent guideline amendment on urethral stricture disease from 2023 emphasizes the importance of determining the length and location of the urethral stricture to guide treatment decisions and patient counseling 1. This approach allows for personalized care and improves outcomes by matching the treatment to the specific characteristics of the stricture and the patient's needs. Therefore, it is crucial to prioritize the diagnosis and treatment of urethral stricture based on the most current evidence and guidelines to minimize morbidity, mortality, and improve quality of life.
From the Research
Urethral Stricture and Bladder Closure
- A urethral stricture is a narrowing of the urethra, which can cause obstructive urinary symptoms 2, 3.
- The provided studies do not directly address whether a urethral stricture can completely close off a bladder.
- However, they do discuss the use of alpha blockers to improve urinary symptoms and reduce the risk of recurrent acute urinary retention in men with urethral catheters 2, 3.
Alpha Blockers and Urinary Symptoms
- Alpha blockers, such as alfuzosin and tamsulosin, have been shown to relax prostatic smooth muscle cells and decrease resistance to urinary flow, improving urinary symptoms 2, 3.
- The studies suggest that alpha blockers can increase the success rates of trial without catheter and reduce the incidence of adverse effects 2, 3.
- However, the evidence does not directly relate to the question of whether a urethral stricture can completely close off a bladder.
Ureteral Stent-Related Discomfort
- A study on the beneficial effect of alpha-blockers for ureteral stent-related discomfort found that both alfuzosin and tamsulosin showed lower scores compared with placebo for urinary symptom score and body pain score 4.
- However, this study does not provide information on the relationship between urethral stricture and bladder closure.
Conclusion Not Available
There are no research papers available to directly answer the question of whether a urethral stricture can completely close off a bladder.