• top-urologist-nyc-bpd-ed-prostate-cancer-01
  • best-top-urologist-upper-east-side-ues-nyc
  • top-urologist-nyc-vasectomy-implants-prostate-03

Putting Patients First

Welcome to Fifth Avenue Urology, the practice of Dr. Yaniv M. Larish. We are located in Manhattan, in New York City’s beautiful Upper East Side. We offer the most advanced state of the art diagnosis and treatment for all problems of the male and female urological and reproductive systems.

Dr. Larish served as the former chief resident of Urology at Lenox Hill Hospital. Drs. Larish is focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. At Fifth Avenue Urology, we view the ability to practice medicine as a privilege, not a right. They treat their patients with respect, professionalism and compassion.

Urological Services
Common Problems

Schedule an appointment today

212-675-3186

Yaniv M. Larish, M.D.

dr-yaniv-larish-fifth-avenue-urology2Dr. Larish is a urologist and surgeon treating women and men with a variety of urological conditions. His expertise is in treating complex kidney stones, enlarged prostates (BPH), incontinence, erectile dysfunction, infertility, and urological oncology (prostate, bladder, kidney, and adrenal cancers). He is an expert in general urology and is often consulted for second opinions.

Dr. Larish’s dedication to patients and their families drives his belief in prompt evaluation and care. He treats all his patients like family. As such, same day appointments are available for urgent issues and house calls can be made in select cases.

Read more >

Category Archives: urethral stricture doctor nyc

Urethral Stricture Causes & Treatment

What is a urethral stricture? The urethra is a tube that transfers urine from the bladder to the penis. This hollow tube starts from the lower bladder opening, stretching throughout the length of the penis. In women, the length of the tube is around 2.5 to 4 cm in length. The opening of this tube is short in contrast to men’s, stretching from the lower bladder. The urethral sphincter is a muscle surrounding the urethra in both women and men. This muscle keeps the urine inside the bladder by closing the urethra. The muscle relaxes before urination, allowing the urine to pass through the urethra from the bladder.

Urethral Stricture | Causes & Treatment NYC
(Source)

Causes of a Urethral Stricture

The urethral stricture shrinks the opening of the urethra. This usually happens when the tissue starts to swell because of scar tissue. The tissue might scar for numerous reasons and factors. Men with penile implants and young boys with hypospadias surgery have a higher risk of developing urethral strictures.

A common type of trauma, straddle injury, may lead to urethral stricture. For instance, if you fall on fences and hit the area near your scrotum, you might develop a straddle injury. Here are some other causes of urethral stricture:

  • Catheter insertion
  • Pelvic fractures
  • Radiation
  • Benign prostatic hyperplasia
  • Prostate surgery

Here are some rare causes of urethral stricture:

  • Chlamydia, gonorrhea, or other sexually transmitted infections
  • Repetitive or untreated urinary tract infections
  • A tumor developing near your urethra

Symptoms of Urethral Stricture

The most common symptom of urethral stricture is a weak urinary system. Here are some symptoms of urethral stricture:

  • Pain while urinating
  • Straining when urinating
  • Prostatitis
  • Urinary tract infection

People who are unable to develop severe urethral strictures lose their ability to urinate. This is a medical emergency, and you can refer to it as urinary retention. Renal failure and hydronephrosis might occur due to poor drainage of your bladder, and it fills in the kidney.

The urethral stricture will lead to inflammation in the prostate region. The prostate surrounds the urethra under your bladder. You can refer to this condition as prostatitis. You might develop a urinary tract infection due to urinary backup. You can manage this condition using antibiotics and treating the urethral stricture. More importantly, you should visit a urologist for diagnosis and suitable treatment options.

Diagnosis of Urethral Stricture

Your doctor will use different approaches for the diagnosis of urethral stricture:

·       Understanding the Symptoms

When you visit the doctor, they will ask various questions to identify the symptoms you are experiencing. You can also self-report the symptoms if they are prominent. Furthermore, the doctor will ask about your medical history to recognize the risk factors of the condition.

Urethral Stricture Treatment | Top Urologist NYC
(Source)

·       Undergoing Physical Examination

The urologist will perform a simple physical examination and try to identify the urinary stricture. For instance, the possible symptoms that the doctor will observe while the physical inspection is redness, swell, and harness on the penile region.

·       Conducting Tests

To identify the condition and diagnosing the urethral stricture, the urologist will also perform these tests:

  • Gonorrhea or chlamydia
  • Measuring urethral opening’s size
  • Measuring flow rate while urinating
  • Analysis of chemical and physical urinary properties and determine the presence of bacteria.
  • In this diagnosis process, the urologist will insert a small tube containing a camera. This device helps the doctor to view the urethra and bladder. This way, they can ensure the presence of the condition.

Treatment of Urethral Strictures

The treatment process will depend on your condition’s severity:

·       Nonsurgical

Dilator – The urologist will use a dilator to widen the urethra. The dilator is a medical instrument and helps with the primary treatment mode. This procedure is outpatient, and you can return home after the treatment. The doctor will pass a small wire in the bladder through the urethra and start dilating. After some time, the urologist will start using the larger dilators to increase the urethra’s width.

Catheter – In another nonsurgical option, the urologist will insert a urinary catheter permanently. Doctors only opt for this treatment in severe cases. This procedure has risks such as urinary tract infection and bladder irritation.

·       Surgery

If nonsurgical treatment does not work, the urologist will perform surgery to remove the affected tissue. For severe and longer stricture, you can go through open urethroplasty. The urologist will remove the tissue and reconstruct the urethra.

·      Urine Flow Diversion

In severe cases, the urologist will use the procedure for complete urinary diversion. The surgeon will reroute the urine to the abdomen’s opening. They will use the intestines and connect the opening to the ureters. The surgeon will perform this treatment when they find the need to remove the damaged bladder.

Other Surgical Options for Urethral Stricture

The surgeon will recommend you, anyone, out of these surgical options, depending on your condition:

  • DVIU or direct vision internal urethrotomy
  • Urethral dilation
  • Open urethral reconstruction
  • Urethral stent placement

Urethral Strictures: Conclusion

If you experience pain or strain while urinating, consult with one of the best urologists in New York City, Dr. Yaniv Larish. You can set-up an appointment with the urologist by contacting us at 212-675-3186 or visit our main website to learn more: Fifth Avenue Urology.

What is a Urethral Stricture?

Urethral stricture: An Overview

The narrowing down of urethra, the tube via which urine passes from the kidneys to the bladder, is known as urethral stricture. Formation of scar tissue inside a specific segment of the urethra causes the stricture.

An individual with urethral stricture will experience difficulty urinating, and the urine will fill up the urinary tract.  Consistent deposition of urine in the urinary tract could eventually cause kidney malfunction and damage. The condition predominates in males as they have a longer urethra than females, rendering the former more vulnerable to stricture compared to latter.

Urethral Stricture Symptoms

We always advise individuals with urethral stricture to opt for treatment as early as possible to prevent kidney infection and formation of kidney stones. The urinary bladder could expand and stop functioning in due course if and when urinary retention becomes chronic. We tell patients to watch out for the following symptoms of urethral stricture:-

  • Urgent urination (a strong urge to urinate frequently)
  • The feeling of bladder fullness
  • Taking a long time to urinate
  • Recurrent urinary tract infections
  • Experiencing pain during urination
  • Straining to urinate
  • Urine emerging in a thin stream
  • Distension of the adjacent organs including the penis

Causes of Urethral Stricture

More often than not, the condition tends to be idiopathic, i.e. the exact cause behind urethral stricture remains unknown. However, a few risk factors are alleged to be linked to the stricture. An individual could be at risk of developing urethral stricture if he has/had:-

  • STD (sexually transmitted disease)
  • Undergone radiotherapy for BPH (benign prostatic hyperplasia)
  • Been operated upon for a prostate or bladder problem
  • Used catheter
  • Prostatectomy
  • Prostrate brachytherapy (radiation therapy for prostate cancer)
  • Suffered a trauma due to injury in the area surrounding the scrotum

Diagnosis

To confirm whether someone has a urethral stricture, we perform a physical test, enquire about medical history, and symptoms. Furthermore, we suggest patients opt for one or more of the following tests for ascertaining the exact location, extent, and cause          of the stricture:-

  • Urinary flow assay
  • Urinalysis
  • Pelvic ultrasound
  • Urethral ultrasound

Conducting a Cystoscopy enables us to confirm a diagnosis. We insert a cystoscope inside (a tubular device carrying a small camera) into the urethra to scan its entire span. The camera lens helps us to locate the stricture as well as the level of constriction or narrowness.

After that we study X-rays (Retrograde urethrogram) to identify the length of the stricture.

Treatment

We place a urethral stent or perform urethroplasty following confirmation of the presence of urethral stricture. We conduct urethroplasty for the sake of restoring the urethra to its original shape or form. The procedure entails eliminating the stricture, and grafting tissue from the patient’s body and positioning it in the urethra for widening it.

In some cases, we place a stent within the narrowed section of the urethra to keep it wide enough for urine to pass through smoothly.

Conclusion

We always recommend individuals diagnosed with urethral stricture to seek medical intervention. We counsel patients on different surgical procedures.

Our Urologists advise patients who’ve undergone surgery for urethral stricture to remain in touch. The stricture could recur even after successful surgery, and hence, it is important to regularly consult our urologists in NYC for monitoring symptoms.

Our exceptionally qualified urologists at Fifth Avenue Urology have been and continue to deliver superlative urological services. Dr. Michael Brodherson, M.D. is a veteran, specializing in gynecological operative procedures and complicated surgeries. He has amassed many years of experience performing open urological operations.

Dr. Larish is a surgeon and urologist with wide-ranging experience in the treatment of adrenal, kidney, bladder, and prostate cancers, and infertility. Dr. Glickman is adept in carrying out minimally invasive surgeries for various urological issues. In this blog, we shed light on urethral strictures.

For a confidential consultation, contact us today:

FIFTH AVENUE UROLOGY
212-675-3186

 

References

  1. https://www.gaurology.com/urethral-stricture-males/
  2. https://www.medicalnewstoday.com/articles/324983.php 
  3. https://www.mayoclinic.org/diseases-conditions/urethral-stricture/care-at-mayo-clinic/mac-20362386

What is Urethroplasty?

If you have problems relating to urethral strictures, urethroplasty is the surgical route to resolving them. If urethroplasty has been recommended to you, or you have a urethral stricture and want to know more about the surgery that could fix it, then here, we take a look at what you can expect:

What Are Urethral Strictures?

A urethral stricture is a blockage in the urethra caused by scarring. This can be the result of various factors, but is quite often caused by injury or surgery. Strictures can occur anywhere in the urethra, with those closest to the bladder known as posterior strictures, and those within the penis known as anterior strictures. They can make voiding the bladder painful or difficult, and cause other urological complications. Urethroplasty works to repair the stricture, or in some cases, other defects within the urethral walls.

How Is Urethroplasty Performed?

Urethroplasty is a fairly common type of surgery, and has a low incidence of complications, however it is not a minor surgery and the majority of urethroplasty patients do need to stay in hospital for between one to seven nights, depending on the specifics of their surgery and the observations that need to be made during recovery.

There are several different methods of urethroplasty, and the one that is right for you will depend on the size and position of the stricture, the tissue available for any grafting necessary, and various other factors including your general health and physiology. Usually, decisions relating to how your urethroplasty will be performed can be made after a urethography, which is a radiographic scan of the affected area.

Because urethroplasty surgeries can vary so much, the anesthetics used can range from sedation through to general anesthetic, and surgery time can be anything from one to eight hours.

After the Surgery

Urethroplasty is considered fairly low risk as surgeries go, and is well tolerated by most people who undergo it. After surgery, less than 10% of patients experience complications that could be considered serious. In general, the complications that relate to urethroplasty – aside from those such as post-operative infection which exist for any kind of surgery – relate to urination, erection and ejaculation. These are usually temporary and minor.

If you are suffering because of urethral strictures, please book an appointment today at 212-675-3186 so that we can look at your case and talk about whether urethroplasty is the best way to fix your problems!

What Are Urethral Strictures?

Urethral strictures are a relatively common urological problem, where the walls of the urethra have defects that can make voiding the bladder difficult and painful. If you are having problems with urinating comfortably, it is important to make an appointment and have this checked out. Urethral strictures can be treated successfully, if this is the cause.

Why Do Urethral Strictures Form?

Urethral strictures are caused by scarring to the walls of the urethra – the thin tube that carries urine from the bladder, through the penis and out of the body. These scars can be caused by a number of factors, but the most frequent things that lead to urethral strictures are injuries and surgery.

Urethral strictures can cause problems both with urination and sexual performance, as the urethra in men is involved in ejaculation.

One complication that can arise from having urethral strictures is urine retention – where the bladder is not emptied properly. Over time, this can lead to bladder stones and other issues.

Types of Urethral Strictures

A urethral stricture can form anywhere in the tissue of the urethra. Strictures that form in the first portion of the urethra, nearest to the bladder, are called ‘posterior urethral strictures’. Those which form from the perineum down to the tip of the penis are called ‘anterior urethral strictures’.

Urethral strictures can also vary in length and severity. A urethography will allow a urologist to see where strictures are present, and pinpoint their type, size and location, ready to recommend a course of treatment. This is a simple radiographic procedure using dye to highlight the urethra itself.

Urethral Strictures and Urethroplasty

urethral-strictureWhere urethral strictures need surgical treatment, a urethroplasty is the usual course of action. This is a procedure that can be performed in a number of ways, depending on the size and location of the stricture, and is usually done under general anesthetic. The aim is to fix the urethral wall and resolve any symptoms the patient is experiencing from their stricture.

While urethroplasty is not regarded as a minor surgery and usually involves a hospital stay, it has a very high success rate and low rate of complications.

If you are experiencing symptoms that could be due to a urethral stricture, or you have a previously diagnosed urethral stricture that you would like to address, please make an appointment today at 212-675-3186 so we can look at your case and discuss your options!

Urethral Stricture Doctor NYC

What are Urethral Strictures?

Urethral strictures are scar tissue or an abnormal tightening of the urinary tube which carries urine out of the body from the bladder. If you are having difficulty starting or have a slow stream when urinating, call your urologist NYC today to set up an appointment, it could urethral strictures.

Causes of Urethral Strictures

Urethral strictures may be caused from an inflammation, surgery, disease or an injury to your urethral tube. Occasionally yet rare, a tumor near the urethra may cause a pressure which will slow or block the flow of urine. Urethral strictures can occur from sexually transmitted diseases and from procedure such as a catheterization.

The SymptomsUrethral Strictures

The symptoms vary with each case of urethra stricture, the symptoms can be singular or you can have multiple symptoms. The most common symptoms are:

· Blood in your semen

· Decreased urine output

· Frequent or urgent urination

· Pain during urination

· Swelling of the penis

· Discharge from the urethra

Examinations and Tests

Your urologist can determine the best course of treatment to treat your condition during the physical examination and your medical history is completed. The most common tests are:

· Post Void Residual Volume

· Urethrogram

· Tests to Check for Sexually Transmitted DiseasesUrethral Strictures

· Urinalysis

· Urinary Flow Rate

· Cystoscopy

 

 Treatments

At this time there are no medications which can guarantee a decrease your urethral strictures. The treatments which have a success rate are:

· Cystoscopy-this procedure widens (dilates) the urethra by inserting a thin instrument into it by stretching the urethra, under a local anesthesia.

· Surgical options available are cutting the stricture via a cystoscope or dilating device.

· Urethroplasty-which involves the removal of the stricture and reconstruction of the urethra, done in Urologic Surgery Departments.

· If your urethral stricture is severe enough you may need a suprapubic catheter to allow your bladder to drain. This will be performed by your urologic surgeon.

Often the treatment your urologist and you choose will determine the success rate, and the extent of the damage caused by the stricture. If you notice a change in your urinary habits, please contact the best urologist in New York City!

Top Urologist NYC