Urethroscopy after Urethritis
Sexually Transmitted Infections
Inflammation or trauma may produce changes in the walls of the urethra which result in a narrowing of the lumen. This narrowing is caused by the contraction of the fibrous elements in the scar tissue and an acquired stricture is formed. Campbell (1929) found that 90 per cent. of 1,224 cases of stricture were of inflammatory origin, and stated that stricture formation depends on the severity rather than on the duration of the original infection. The formation of a stricture is a continuing
... a continuing process over a long period of time. McCrea (1940) states that in 126 men questioned about the dates of their gonorrhoeal infection and their symptoms of stricture, the minimum intervening period was two years. He also stated that Gouley had implied that stricture formation followed severe loss ofepithelium. Stephenson (1956) found strictures in 5 per cent. of 243 men investigated for urethral discharge, but gave no details as to when urethroscopy was carried out. Dunlop (1961) , four weeks after urethritis appeared to have responded to treatment, found strictures in 4-6 per cent. of 498 patients undergoing routine examination of the urethra by instruments; the sites of the strictures were detailed, but not the types of strictures found, with the exception of two of probable congenital origin. Such a high incidence of stricture seemed at variance with the clinical impression of myself and others, and prompted a review of the findings at one small clinic. Material The case notes of 598 consecutive patients were reviewed and classified into the following groups: Group A.-Forty-two patients with signs and symptoms referable to the urethra but with no signs of an active urethritis; 39 (93 per cent.) underwent urethroscopy.