Current indications for MukoCell® include treatment of urethral strictures (see figures) and hypospadias. A urethral stricture is a narrowing of the urethra, mainly caused by injury and infection. Complications of a urethral stricture are, for example, a high risk of infection, difficulty emptying the bladder, pain, renal damage, kidney stones and sexual dysfunction.
Patients with a narrowing of the urethra / stricture currently have three main treatment avenues available to them:
Narrowings of the urethra are referred to as urethral strictures in the medical language. Those narrowings are often caused by scar tissue, impairing urinary flow. Urethral strictures may be congenital or acquired. Congenital strictures are rare. Other than strictures so-called hypospadias can occur. In this disorder the urethra sometimes ends before reaching the glans. The majority of the narrowings of the urethra develop only later in life. Almost exclusively men are affected. Approximately six out of a thousand men will be affected at some point in their life.
Common causes for the acquired urethral stricture:
- Bacterial infections of the urethra (e.g. in case of gonorrhea)
- Infections of foreskin or glans
- Injuries in the pelvis or dam region
- Urethral intervention, e.g. lectern, cystoscopy, sexual practices using foreign objects, surgeries via the urethra
- Tumours of the urethra
However, in a large number of patients no cause can be found. Each urethral stricture should be treated. There are several treatments possible, depending on the nature of the stricture. One option would be the gentle reconstruction of the strictured urethral part using tissue replacements (Urethral Plastics). The tissue replacement, an autologous graft, is cultivated from the patients’ own oral mucosa cells in the laboratory. This innovative method of treatment is particularly gentle and rather painless.
The examination of the urethral stricture and a suitable treatment is carried out by a specialist for urology.
The urethral stricture forms gradually and does not lead to changes right away. This is why it is often not noticed until it is already advanced. The following complaints may occur in case of a strictured urethra:
- Weak urinary stream or incontinence: the urinary stream might be twisted or split
- Burning sensation during urination
- Incomplete bladder voiding: Patients sense residual urine in the bladder
- Complete urinary retention (Inability to urinate)
- Frequent urge to urinate
- Blood in the urine
- Heaped urinary tract infection
The symptoms are not specific for a urethral stricture and may also indicate to other diseases. In case of a urethral stricture there is an increasing resistance while urination. That’s why the bladder is often not emptied completely. This promotes the occurence of bladder infections (cystitis). Furthermore, an increased bladder pressure can result in bladder distension as well as diverticula in the bladder wall. Subsequently, renal congestion can occur which leads to kidney damage. Recurrent infections of the bladder, prostate or epididymis can also arrive.
- At the beginning of the examination you will be questioned about your medical history by the doctor, e.g. „Since when did your complaints exist?“ or „Did you have infections of injuries ?“.
- Urine is examined in the laboratory to prove or exclude a urinary tract infection.
- Furthermore, the urine flow rate is measured. Based on the measurement results a stricture can often be diagnosed.
- In addition, an ultrasound examination is often performed. This allows to determine the residual urine volume in the bladder. The condition of bladder and kidneys can also be examined.
- An X-ray provides the precise localization of the stricture in the urethra and its length.
- After having performed all these examinations, there is rarely a need for a
- urethral endoscopy to get a more precise idea of the stricture.