Page 12 - Urological Health

8. What is a urethral stricture and how would I know if I have one?

A urethral stricture is an abnormal narrowing of the tube that carries urine out of the body (urethra).
This can be something you are born with (congenital) or something that is the product of an injury
or infection of the urethra.

Examples of a urethral stricture include:
• a straddle-type injury that compresses the urethra against the bones of the underside of
the pelvis;
• certain sexually transmitted infections, such as chlamydia or gonorrhea; and

• after surgery on the urinary tract.
People with urethral strictures will notice changes in their urination, which can be difficult to
distinguish from other causes of urinary obstruction, such as benign prostatic enlargement. There
will often be difficulty starting urination, and the stream will be weak and might require straining to
help it flow. Strictures near the end of the urethra can be associated with a urinary stream that sprays
rather than stays together in a typical column of fluid.
People with a history of injury, infection or surgery to the urinary tract, or young children, with
symptoms like those above might have a urethral stricture, and your urologist will keep these things
UNDER REVIEW
in mind when you are discussing your urinary symptoms.
The best way to assess for a stricture is through urethroscopy,when asmall camerais inserted into
the urethra in the direction of the bladder. A narrowing or stricture will be obvious to the urologist.

9. Do over-the-counter herbal medications help with my sex life

or urinary problems?

In recent years, the use of medications for the treatment of sexual problems (such as erectile
dysfunction or low sex drive) and urinary problems (such as bladder overactivity and enlarged
prostate) have taken centre stage, and have improved many people’s quality of lives, and spared more
invasive surgical treatments. It follows that some people seek the same benefits as these medications,
but in a form they may consider more “natural.” There is no shortage of these herbal treatments for
sexual or urinary problems, and in some cases the biological explanation of their worth seems very
reasonable. The list of these is far too long for this chapter to cover adequately.

There is also no doubt that there are men and women who have taken these supplements or
remedies and have noticed an improvement in the problem they sought to treat. The difficulty arises,
however, in truly finding the reasons why the treatment seems to have worked. Modern evidence-
based medicine holds that a therapy should be shown to have the desired effect when compared no
active therapy (the placebo)orto the current standard therapy (these are called controls). The key to
these trials is that neither the provider nor the patient should be aware if they are taking the new
treatment or the control (this is called double-blinding), and that the patients are randomized to
treatment – that is there is no ability to purposely select a particular patient to receive either the study
drug or the control. These trials ensure that the new treatment is effective and that it is safe, when
compared to no treatment or to the current best option.

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