meatal stricture, for example, with coronal hypospadia
bulbar stricture, for example, Cobb's collar
Acquired:
inflammatory:
urethral catheterisation - common in the UK; it is influenced by:
duration of catheterisation - prolonged pressure on the wall of the urethra produces a zone of ischaemia that heals with a scar. The most common sites are those where the urethra is most narrow e.g. the external urethral meatus, and at points of angulation e.g. the penoscrotal junction
catheter material and other chemicals e.g. lubricants
associated infection
balanitis xerotica obliterans - often diagnosed late
endarteritis obliterans - radiotherapy causing tissue damage and ischaemia
traumatic:
instrumentation - especially, at the membranous urethra
injury to the anterior urethra from a "fall astride" - the bulbar urethra is crushed against the under surface of the pubic bone
injury to the posterior urethra in association with pelvic fractures; bulbar urethra may also be injured
infective:
gonorrhoea - less prevalent today
non-specific urethritis
tuberculosis
neoplastic:
invasion from prostatic adenocarcinoma
squamous carcinoma - usually in association with chronic stricture where urinary stasis has given rise to squamous metaplasia
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