There is no substitute for the comprehensive, integrated urological care that only a multi-physician, single specialty practice like KBU can offer.

Female Vaginal Prolapse

Female vaginal prolapse, or pelvic organ prolapse, occurs when the structures of the pelvis protrude into or outside of the vaginal canal. Frequent sites of pelvic organ prolapse include the bladder, urethra, uterus, vagina, small bowel, or rectum. The condition is experienced almost entirely by adult women.

Pelvic organ prolapse is caused most commonly by pregnancy, labor, and childbirth. During labor, the nerves of the vagina may be compressed and injured by the movement of the baby through the birth canal. Damage to the nerves in the pelvis can also be caused by a forceps delivery or an episiotomy.

Diseases that cause increased pressure in the abdomen, such as obesity, respiratory problems with a long-lasting (chronic) cough, constipation, and pelvic organ cancers can also lead to pelvic organ prolapse. The condition can also occur after hysterectomy for another gynecological health problem, such as endometriosis, dysfunctional uterine bleeding or uterine fibroids.

Urethral Stricture Disease

A urethral stricture is a narrowing of the urethra--the tube that carries urine from the bladder to be released outside the body. For men, the urethra also carries semen from the reproductive tract during ejaculation. The stricture can cause a partial or complete blockage in urine flow. It is usually caused by scarring in or around the urethra--scarring that can result from surgery, disease or injury.

Frequent urination, urinary tract infections, and inflammation or infections of the prostate and content of the scrotum may occur. Left untreated, more severe obstruction of the urethra can result in kidney damage.

Urethral strictures are more common in men because their urethras are longer than those in women, and therefore more susceptible to disease.

Cause of Urethral Stricture Disease

Risk of urethral stricture increases for patients who have experienced trauma, such as an injury to the pelvic region, and those who have a history of sexually transmitted disease (STD), repeated episodes of inflammation of the urethra, or benign prostatic hyperplasia (BPH)-link. Surgery to the prostate, removal of kidney stones, urinary catheterization or cystoscopy (examination of the bladder and urethra using an endoscope, a tube with a small camera) can also increase a patient's risk. However, in many cases, the cause of the stricture cannot be determined.

Symptoms of Urethral Stricture Disease

Some symptoms that may be an indication of urethral strictures in men can include:

  • Burning, painful urination
  • Increased urinary frequency or urgency
  • Slow urine stream
  • Decreased urine output
  • Spraying of urine
  • Blood in urine or semen
  • Abdominal pain
  • Discharge from the penis (yellow or clear, and may or may not contain pus)

In women, symptoms may include:

  • Difficult or painful urination
  • Increased urinary frequency or urgency
  • Fever/chills
  • Nausea/vomiting
  • Abdominal pain
  • Vaginal discharge
  • Pelvic inflammatory disease (PID)
  • Other infections of reproductive organs
  • Fertility problems
  • Pelvic pain
  • Ectopic pregnancy
  • Complications of pregnancy

Diagnosis of Urethral Stricture Disease

Evaluation of the patients with urethral stricture disease includes a physical examination, imaging (such as x-rays using contrast dyes or ultrasound) and sometimes urethroscopy. Urethroscopy involves the insertion of a small, flexible, lubricated telescope into the urethra up to the point of the stricture. This study permits the doctor to see the urethra between the tip of the penis and the stricture.

Treatment of Urethral Stricture Disease

Treatment options depend upon the length, location and degree of scar tissue associated with the stricture. Many strictures can be enlarged by--the gradual stretching of the urethra using a thin instrument inserted into the urethra under local anesthesia. Surgical options include cutting the stricture with a laser or knife through a telescope (urethrotomy). For longer strictures, the surgeon can remove the stricture and reconnect or rebuilt the urethra using grafts of other tissue.

Patients should be monitored by a urologist following urethral stricture repairs because there is a high rate of recurrence.

There are no drug treatments currently available for this disease.

At Klein & Birns Urology, our aim is to be the leader in providing the highest quality and most comprehensive urologic care in New York. Find out how Klein & Birns Urology can serve you and your family by calling (212) 744-8700 or by making an appointment.