Pitfalls

Some strictures are associated with other conditions, and elements of the history may be unclear; however, the acute management remains the same. It is important to consider the following when a diagnosis of stricture is made as the cause for AUR.

1. When attempting urethral catheterization and encountering resistance at the level of a stricture, it is imperative not to attempt to force a catheter through a stricture, as false passages can be easily created, which can cause problems when it comes to definitive management procedures.

2. Some patients may have undergone previous surgery to the bladder neck, such as TURP, radical prostatectomy, or bladder neck incision, which are known to cause stenosis and obstruction in some cases. The acute management is the same, however, as indicated above.

3. It is essential in these patients that a full sexual health history is taken to exclude sexually transmitted infection as a cause, and also to allow formal contact tracing if indicated.

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