Does your urethra feel blocked? Let's talk about Posterior Urethral Stenosis (PUS)

Do you also feel very difficult when urinating ? Does the urethra feel narrow? Or does it feel like the bladder has not completely emptied even after urinating ? These are not good symptoms to just ignore. Today we are talking about a very important topic that many people are reluctant to talk about. That is a condition called Posterior Urethral Stenosis.

Simply put, what is Posterior Urethral Stenosis (PUS)?

This may sound like a scientific name, but it's actually quite simple to understand. Posterior Urethral Stenosis (PUS) , sometimes called Urethral Stenosis or Urethral Stricture , is a condition in which the part of the urethra (posterior urethra) closest to the bladder becomes narrowed, or more accurately, blocked.

Just like when something gets stuck in a water pipe, the water flow slows down, and this is what happens when our urine becomes blocked. Sometimes this blockage can be so severe that it becomes very difficult to urinate , and sometimes it can even lead to the inability to urinate at all.

This condition is more common in men than in women. The reason for this is that the male urethra is much longer than the female one. While a man's urethra is about 8-9 inches long, a woman's is about 1.5 inches long. So, the 1-2 inch section of the male urethra, closest to the bladder, is most likely to become blocked in this way. This section also includes the part that passes through the prostate gland.

How common is this condition?

Posterior Urethral Stenosis is actually not that common. Most of the time, this condition occurs as a side effect of treatment for another condition in that area. Very rarely, this condition can be present at birth (congenital). It is very rare in women.

Do you also have these symptoms?

A person with this condition may exhibit one or more of the symptoms below. See if you have any of these too.

Why is this happening? What are the main reasons?

As we mentioned earlier, this condition can rarely be present at birth. However, most often it occurs as a result of an accident or medical treatment performed in that area.

Here are some of the main reasons:

• Pelvic Fracture: A serious accident that causes damage to your pelvic bone and injury to your urethra.
• Treatments for prostate cancer: This condition can occur later due to treatments for prostate cancer such as radiation therapy, brachytherapy, external beam radiation therapy (EBRT), and surgical removal of the prostate (prostatectomy).
• Surgery for BPH: This condition can also be caused by surgeries such as TURP (Transurethral Resection of the Prostate) for Benign Prostatic Hyperplasia (BPH).

What happens if left untreated?

This is the most important thing. If you think, "It will get better on its own" even when you have these symptoms, the situation can get worse. If that happens, serious complications such as:

• Frequent urinary tract infections (UTIs).
• Permanent damage to the bladder.
• Urine flows backward from the bladder towards the kidneys (vesicoureteral reflux).
• Kidney damage.

Doctor, how do you diagnose this?

When you go to see a doctor, he will first listen carefully to your symptoms. He will also ask about your medical history. Then he will do a physical examination. To confirm the exact nature of your condition, he may also do several tests, such as:

• X-ray tests
• Ultrasound scan
• Cystoscopy (examination of the urethra using a small tube with a camera)
• Retrograde urethrogram
• Voiding cystourethrogram (VCUG)

Can this condition be completely cured?

Yes, absolutely. There are treatments for this. This is not a disease that can be cured with medication. However, it can be treated through two methods. Your doctor will determine the most appropriate treatment for you based on the nature of your condition, the amount of scar tissue, and the length of the blockage.

1. Urethral Dilation

This involves widening the blocked part of the urethra using special instruments (such as long, thin rods) or a balloon. This is a relatively simple procedure. However, it is not a permanent solution. You may need to do this treatment several times.

2. Surgery (Urethroplasty)

This is the most successful and permanent solution. In this surgery, the damaged, blocked part of the urethra is repaired or a new part is transplanted. The success rate of this surgery is more than 80%.

What happens after treatment?

After urethral dilation, you will usually start to feel better within a week. After urethroplasty surgery, it can take two to three weeks to fully recover.

The important thing is that this condition can sometimes recur even after treatment . So, don't forget to go to follow-up appointments as your doctor tells you. That way, he can monitor your condition and identify any problems early.

Are there ways to avoid this?

Not all of the causes we discussed earlier can be prevented. For example, it is difficult to prevent this from happening after cancer treatment. However, you can reduce this risk by avoiding injuries to the hip area.

• Wear your seat belt every time you ride in a vehicle.
• If you play high-impact sports like hockey or football , wear proper protective clothing and equipment .
• Eat foods rich in calcium and vitamin D, which strengthen bones.
• Engage in bone-strengthening exercises (especially weight-lifting exercises).
• Stop smoking and excessive alcohol consumption . These affect the density of your bones.
• If necessary, ask your doctor about bone-strengthening medications (bisphosphonates).

When should I go to the Emergency Treatment Unit (ETU)?

This is very important. If you have any of the following symptoms, do not waste time and go to the nearest hospital Emergency Department (ETU) immediately.

What questions should you ask the doctor?

When we go to see the doctor, sometimes we forget what we want to ask. So, write down these questions on a piece of paper.

• Why does the doctor think I have this condition?
• What is the reason for my condition?
• How severe is my urinary tract obstruction?
• What is the best treatment option for me?
• What are the advantages and disadvantages of each treatment?
• How should I take care of myself after treatment?
• How soon should I come back for follow-up?
• Do you think this situation will happen to me again?
• Is there anything I can do to prevent this from happening again?
• Do I need to see a specialist (urologist) about this?

Posterior Urethral Stenosis, PUS, Urethral Stricture, Urinary Tract Blockage, Difficulty Urinating , Urinary Diseases, Men's Health, Urethroplasty, Urethral Dilation, Urinary Tract Infection