Membranous Urethra: Symptoms, Causes, Treatment

What are the symptoms of membranous urethra?

Membranous urethral obstruction (MUI) is a condition where the urethra is blocked by a thin layer of tissue called the membrane, which is located at the junction of the urethra and bladder. The symptoms of MUI can vary in severity and may include:

1. Difficulty urinating: Men with MUI may experience difficulty starting to urinate, straining to void, or feeling like they are not able to fully empty their bladder.
2. Painful urination: Painful urination is a common symptom of MUI, and may be accompanied by a burning sensation or stinging feeling during or after urination.
3. Increased frequency: Patients with MUI may experience a sudden increase in the frequency of urination, especially at night.
4. Nocturia: MUI can cause nocturia, which is waking up multiple times during the night to urinate.
5. Hematuria: In some cases, MUI can cause hematuria (blood in the urine), especially during or after urination.
6. Incontinence: Men with MUI may experience urinary incontinence, either due to the obstruction or as a result of the underlying condition.
7. Overflow incontinence: Overflow incontinence occurs when the bladder becomes overdistended and urine leaks out uncontrollably.
8. Recurrent urinary tract infections (UTIs): Recurrent UTIs are common in patients with MUI, as bacteria can easily enter the urinary tract through the obstructed urethra.
9. Chronic kidney disease: Untreated MUI can lead to chronic kidney disease and kidney damage.

In some cases, MUI may not cause any symptoms until the condition progresses to a more advanced stage, at which point it may lead to severe complications such as:

• Urethral perforation
• Urethral rupture
• Kidney damage
• Chronic kidney disease

It’s essential to seek medical attention if you experience any symptoms of MUI or if you have a family history of the condition. Early diagnosis and treatment can help prevent complications and improve quality of life.

What are the causes of membranous urethra?

Membranous urethral obstruction (MUI) is a condition where the urethra is blocked by a thin layer of tissue called the membrane, which is located at the junction of the urethra and bladder. The causes of MUI are not fully understood, but several factors have been identified as potential contributors:

1. Congenital defects: Some cases of MUI may be due to congenital defects in the development of the urethra or bladder.
2. Infection: Inflammation or infection of the urethra or bladder can cause scar tissue to form, leading to obstruction.
3. Trauma: Trauma to the urethra or bladder, such as a fall or pelvic fracture, can cause damage to the tissue and lead to obstruction.
4. Cancer: Cancer of the urethra or bladder can cause obstruction due to tumor growth or invasion of surrounding tissues.
5. Benign prostatic hyperplasia (BPH): Enlargement of the prostate gland can compress the urethra and cause obstruction.
6. Neurogenic bladder: Neurological disorders, such as multiple sclerosis or spinal cord injury, can cause changes in bladder function and lead to obstruction.
7. Urethral stricture: Scarring or narrowing of the urethra due to inflammation, trauma, or other factors can cause obstruction.
8. Prior surgery: Previous surgical procedures on the urethra or bladder can increase the risk of developing MUI.
9. Age: MUI is more common in older adults, likely due to age-related changes in the urinary tract and increased risk of underlying medical conditions.
10. Family history: A family history of MUI or other urological conditions may increase an individual’s risk of developing MUI.

It’s essential to note that MUI can occur without any apparent cause, and in some cases, it may be diagnosed incidentally during a routine urological examination.

How is the diagnosis of membranous urethra made?

The diagnosis of membranous urethral obstruction (MUI) typically involves a combination of physical examination, medical history, and diagnostic tests. The following steps are commonly used to diagnose MUI:

1. Physical examination: A digital rectal examination (DRE) is performed to assess the prostate gland and evaluate for any abnormalities.
2. Medical history: A thorough medical history is taken to identify any symptoms, medical conditions, or previous surgeries that may be related to the obstruction.
3. Uroflowmetry: Uroflowmetry is a test that measures the flow rate of urine during urination. A slow flow rate or straining during urination may indicate obstruction.
4. Post-void residual (PVR) measurement: PVR measurement is a test that measures the amount of urine left in the bladder after urination. An increased PVR may indicate obstruction.
5. Cystoscopy: Cystoscopy is a procedure that involves inserting a flexible tube with a camera and light on the end (cystoscope) through the urethra to visualize the inside of the urethra and bladder.
6. Ultrasound: Ultrasound imaging can be used to visualize the kidneys, bladder, and urethra to assess for any abnormalities or blockages.
7. Magnetic Resonance Imaging (MRI): MRI can be used to evaluate the anatomy of the urethra and bladder and rule out other causes of urinary symptoms.
8. Voiding cystourethrogram (VCUG): VCUG is a test that involves injecting contrast material into the bladder through a catheter while taking X-ray images to visualize the flow of urine through the urethra.
9. Urodynamic studies: Urodynamic studies involve measuring the pressure and flow of urine during urination using sensors placed in the urethra and bladder.

The following laboratory tests may also be ordered to help diagnose MUI:

1. Urinalysis: A urinalysis is performed to evaluate for abnormalities in urine composition, such as blood or protein in the urine.
2. Blood tests: Blood tests may be ordered to evaluate for kidney function, electrolyte imbalances, or signs of infection.
3. Urine culture: A urine culture may be performed to detect bacterial infection or other types of infection.

The diagnosis of MUI is typically made based on a combination of these tests, as well as a thorough medical history and physical examination.

What is the treatment for membranous urethra?

The treatment for membranous urethral obstruction (MUI) depends on the severity of the obstruction, the underlying cause, and the patient’s overall health. The goal of treatment is to relieve the obstruction, improve urinary symptoms, and prevent complications. Here are some common treatments for MUI:

1. Watchful waiting: Mild cases of MUI may not require immediate treatment, and watchful waiting may be recommended.
2. Urethral dilation: Dilation involves using a series of progressively larger instruments to stretch the urethra and relieve the obstruction.
3. Internal urethrotomy: This procedure involves inserting a catheter or other instrument through the urethra to remove the obstructing tissue or membrane.
4. Laser lithotripsy: Laser lithotripsy uses a laser to break up stones or other obstructions in the urethra.
5. Open surgery: In some cases, open surgery may be necessary to repair or remove the obstructing tissue or membrane.
6. Stenting: A stent is a small tube that is inserted through the urethra to keep it open and allow urine to flow freely.
7. Urethral reconstruction: This procedure involves reconstructing the urethra using a patch or graft to repair any damage or scar tissue.
8. Penile prosthesis: In some cases, a penile prosthesis may be implanted to help restore erectile function and improve urinary symptoms.

In addition to these treatments, patients with MUI may also require:

1. Antibiotics: Antibiotics may be prescribed to treat any underlying infections.
2. Pain management: Pain medication may be necessary to manage pain and discomfort during urination.
3. Bladder training: Bladder training techniques may be recommended to help improve bladder function and reduce symptoms.
4. Lifestyle changes: Lifestyle changes, such as increasing fluid intake and avoiding certain activities, may be recommended to help manage symptoms.

It’s essential to work closely with a healthcare provider to develop a personalized treatment plan that addresses the underlying cause of MUI and improves urinary symptoms.