[Changes in the urogenital organs in traumatic strictures of the urethra]

The urogenital tract has been examined in 35 patients who required 3 or more years of therapy. A range of studies revealed a short urethral stricture in 11, long urethral stricture in 26, megalocystis in 6, domicile urinary bladder in 2 and bladder diverticulosis in 6 patients. Simple and diuretic excretory urography showed normal bilateral renal function in 5, moderately impaired function in 14 and severe loss of function in 6 patients. Single-kidney functional impairment was seen in 10 patients. Over 504 of patients showed prolonged urographic retention of urine in the pelvis and ureter. Bilateral ureterohydronephrosis was found in 3 and unilateral one in 3 patients. Descending, ascending and micturitional urethrocystography revealed urinary reflux into the prostate (n = 13), seminiferous ducts (n = 3), seminal vesicles (n = 4) and ureters (n = 4). Vasovesiculographic sizes and shapes of the seminal vesicles were normal in 2 patients while the vesicles were uni- or bilaterally dilated or constricted in other patients. The treatment was operative in 34 patients. Histological examination of scars and resected tissues showed fibrous sclerotic lesions in the prostate and suppurative inflammatory and fibrous lesions in seminal vesicular walls. With long treatment of urethral strictures, micturition disorders were superimposed by reflux of infected urine into the prostate, seminal vesicles and ureters, inducing inflammation and functional abnormalities; these caused shrinkage and compression of the posterior urethra, bladder cervix, intramural and prevesical ureteral segments, resulting in chronic renal failure. An early and radical plastic operation on the urethra may prevent the mentioned disorders.