The urethra is the connection of the bladder to the outside. The urine, which is stored in the bladder, flows through the urethra to the outside. The urethra goes through the pelvic floor, wherein the external sphincter muscle is located.
The male urethra is about 20 cm long. The man's sperm has also access to the outside through the urethra. In the section of the penis the urethra is surrounded from its own erectile tissue. Till the region of the prostate the urethra is lined with the same mucous membrane like the bladder (urothelium).
The female urethra is much shorter. It is 2.5 - 5 cm long. Its external orifice is located in the so-called vaginal vestibule just behind the clitoris.
Urethral stenoses may be congenital (eg hypospadias) or acquired. Causes of acquired urethral stenoses are often injuries or operations through the urethra.
The insertion of a bladder catheter may lead to urethral strictures through minor injuries (microtrauma).
Injuries due to accidents (pelvic fractures, falls on the perineum region and of course, open wounds) cause urethral stenoses.
inflammations of the urethra (urethritis such the gonorrhea / clap) (see below)
Certain tissue diseases (balanitis xerotica obliterans, lichen sklerosus) constrict the urethra
The complaints are initially very slight. The weakening of the urine flow is the main symptom. But through the increased resistance in the urethra it comes to the same changes in the urinary bladder like those caused through a prostate enlargement.
The treatment consists almost always in an operation. Due to the natural shortening of scars, urethral stenoses tend to recur (recurrence).
A urethral diverticulum is an outpouching of the urethra. They can occur in both sexes. In males, weakness of the wall of the corpora cavernosa or injuries of the urethra are often one reason for its development. In females, infection of the periurethral glands can also cause diverticula.
The symptoms consist in dribbling and/or painful urination. The diverticula are often palpable as spherical structures. Sometimes can also pus evacuated from the urethra through pressure on the diverticulum .
Treatment consists of surgery. Then the diverticulum is excised and the urethra sealed again.
A urethral caruncle is a soft smooth red fleshy lesion or red ring of urethral mucosa protruding through the urethral orifice. It is a benign lesion of the distal urethra. It is most often found in postmenopausal women. The main differential diagnosis is with urethral prolapse.
Usually there are no symptoms but sometimes they are painful. Sometimes there may be dysuria and occasionally they can bleed.
If nescessary caruncles can be removed by a surgical excision.
Urethritis is an inflammation of the mucosa of the urethra. Only when a urethritis remains untreated for a long time, the deeper layers of the urethra are also affected. Typically signs include:
The disease is classified as either specific urethritis (caused by Neisseria gonorrhaeae), or non-specific urethritis. The non-specific urethritis is most commonly caused by Chlamydia trachomatis, Trichomonas spp., Ureaplasma urealyticum or Mycoplasma genitalium It might also be caused by chronical irritation (eg indwelling transurethral catheter), viruses or allergenic agents.A
The Treatment consists in of administering antibiotics.
Effects of the urethritis may be stenosis of the urethra (see above), due to the inflammatory scars in the urethra. In particular, the gonorrhea can cause these structures.