Patients with urethral stricture manifest urethral stricture symptoms such as difficulty urinating, a decrease in urine pressure, and a weak urine stream. Therefore, firstly, it must be thoroughly inspected whether or not patients experience these complaints.
In the examination, the outer opening of the urinary canal must be examined and the penis must be inspected for signs of surgical history. Then, the uroflowmetry test, which is known as the urination test, must be performed. This test reveals a weak urine flow rate. The typical “curved stream” of urethral stricture patients is observed. An x-ray of the urethra called a retrograde urethrography is taken.
Retrograde urethrography must certainly be performed on a fluoroscopy table and blindly performed urethral radiography procedures with usual x-ray devices by administering contrast agents must not be preferred. It is better that the urethrography procedure is performed by the surgeon that will perform the surgery. Because the surgeon can adjust the rate of contrast agent injection as she is aware of the degree and location of the stricture in her patient. Therefore, the pain and urethrovascular reflux associated with the administration of the contrast agent with too much pressure will be prevented. Moreover, the surgeon who personally observes the fluoroscopic control will be able to decide whether or not the procedure has been sufficient, and whether or not a voiding cystourethrography is required, meaning whether or not an x-ray will be taken during urination. Therefore, the initial impressions regarding the format of the planned surgery will have formed at this stage, while the patient is still on the fluoroscopy table. During the retrograde urethroscopy procedure, the patient must be placed in a right lateral position on the fluoroscopy table, extend the lower leg straight and bend the upper leg at the knee, moving it to the side as much as possible.
In cases where the doctor deems necessary, magnetic resonance imaging (MRI) and ultrasonography may be performed.