The urethra is the passageway that transports urine (and semen in men) from the bladder to the outside world. In women, is it a short tube, just a few centimetres long, located just above the vagina, whereas in men it is longer, around 20 cm, runs through the penis.
A urinary tract infection (UTI) is an infection of the urinary system, caused by bacteria that has entered the urinary tract. As well as the urethra, this may include the two kidneys, two ureters (the tubes connecting the kidneys to the bladder), the bladder, and the prostate (in men).
UTIs are very common, especially in women. This is because of the location of the urethra in women, and its shorter length. They are usually confined to the urethra and bladder, and are easily treated. However, early management is necessary to avoid the infection spreading to the kidneys, which can be much more serious.
An infection of the urethra is called urethritis. It will cause inflammation, burning or itching, blood in urine (or semen in men) and vaginal or penile discharge. A dose of antibiotics will usually be enough to treat urethritis or a urinary tract infection.
A urethral caruncle is a small growth that appears on the urethra. They are benign (meaning they are noncancerous) and are usually found in women who have been through menopause. Typically they do not cause any symptoms (in fact, they often go by unnoticed) and shouldn’t be a cause for concern. However, if it is causing pain or discomfort, it can be removed surgically.
A urethral diverticulum (UD) is a condition where an abnormality like a pocket or sac forms in the urethra. It is a rare condition that usually occurs in women, but can also occur in men (this is very rare). Symptoms of UD are different for everyone. Some people may not show any symptoms at all, whereas other may experience frequent urinary tract or bladder infections, blood in the urine, pain during sex and pain in the pelvic region, urinary incontinence, amongst other common urologic conditions. Depending on the severity of symptoms, treatment may not be required. However, if it it, surgery is the most effective treatment.
Prolapses occur when the muscles, tissues, and ligaments that support an organ are damaged, causing the organ to become misplaced. When this happens to the urethra, the urethra pushes into the vaginal canal or protrude through the urethral opening. This can cause a whole host of issues with urination. There are a range of treatment options available, depending on the severity of the prolapse. These range from pessaries (devices that help maintain the structure of an organ), to pelvic floor exercises, to surgery.
While he is primarily a urological cancer surgeon, Dr Arianayagam also sees patients with general urological problems, including issues with the urethra.
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