Medical Breakthrough for Those Suffering from the Inability to Urinate Normally

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Dr. Rajveer Purohit and Dr. Jerry Blaivas have developed a urethral stricture staging system for those suffering from the inability to urinate. This cystoscopy-based system can be used almost universally by all urologists and will provide a framework for collecting data that will help determine appropriate follow-up for patients with strictures while also aiding general urologists in knowing which stricture patients should be referred to a reconstructive specialist.

Urethal Stricture

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Having the urge to urinate and not being able to can be caused by a Urethal Stricture; which is a narrowing of the lining of the urethra that inhibits the flow of urine from the bladder. This condition affects both men and women and negatively impacts their quality of life. To better understand what people go through with this condition you can view a video HERE

Those suffering from a Urethal Stricture may have symptoms including:

  • Difficulty starting urine flow    
  • Painful urination    
  • Urinary tract infection
  • Urinary retention
  • Incomplete emptying of bladder
  • Decreased urine stream
  • Dribbling of urine
  • Spraying or double streaming urine
  • Blood in the urine

To demonstrate what a urethal stricture is, in this X-ray, figure 1, dye is injected into the urethra, which looks like a tube and appears dark gray. The stricture is the sharp narrowing in the tube where the arrow is located. This causes the restricted flow of urine.

One of the major problems facing patients with urethral stricture was the lack of a way to categorize strictures so doctors can share information and correctly evaluate the patient’s current stage and progress. That is until now.                                                                                            

The Purohit-Blaivas staging system was developed by 2 prominent New York Urologists, Dr. Rajveer Purohit, and Dr. Jerry Blaivas. It categorizes strictures based on examination with a 16 French flexible cystoscope which is a narrow tubular instrument that is passed through the urethra to examine the interior of the urethra and the urinary bladder.

This is a 5 stage rating system: STAGE 0 represents the absence of any stricture; STAGE 1 describes strictures that allow easy passage of the cystoscope; STAGE 2 allows passage but requires gentle dilation with the cystoscope; STAGE 3 strictures are impassable, but the lumen the space inside any tubular structure in the body is visible; and STAGE 4 strictures are those with a completely obliterated lumen.

Currently, these expert Urologists,Dr. Purohit and Dr. Blaivas are working to refine the staging system so that it takes into account stricture location, number, and length.

“We were prompted to develop this urethral stricture staging system recognizing the lack of a common lexicon for describing anterior urethral strictures and our belief that strictures should be treated as a graded phenomenon for both patient care and research studies,” said Dr. Purohit, clinical assistant professor of urology at Weill Medical College.

This cystoscopy-based system can be used almost universally by all urologists and will provide a framework for collecting data that will help determine appropriate follow-up for patients with strictures while also aiding general urologists in knowing which stricture patients should be referred to a reconstructive specialist.

For further information about this medical breakthrough in the diagnosis as well as treatment options for urethral strictures you can visit their website at http://www.UROCenterOfNewYork.com.

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Ron Romano
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