1. Hypospadias
Hypospadias is a congenital anomaly characterized by abnormal ventral positioning of the urethral meatus, often accompanied by penile curvature (chordee) and incomplete foreskin development. Severity ranges from subcoronal to perineal subtypes. While mild cases may not require intervention, most necessitate surgical correction to restore normal urinary function and penile cosmesis. Classic presenting signs include urinary stream spraying and ventral glans groove deformity. Diagnosis is typically confirmed during neonatal examination.
2. Male anterior urethral stricture
The most common manifestations of urethral stricture are reduced urine flow and incomplete bladder emptying, but it can also present as urinary tract infection, epididymitis, increased residual urine volume, or decreased ejaculation ability. In addition, patients may experience urinary spraying or dysuria. In males, a urethral stricture refers to a narrowed segment of the anterior urethra due to a process of fibrosis and cicatrisation of the urethral mucosa and surrounding spongiosus tissue (“spongiofibrosis”).
3.Male posterior urethral stricture
In the male posterior urethra, there is no spongiosus tissue and at this location the terms stenosis is preferred. Posterior urethral stricture refers to a disease characterized by luminal narrowing in the posterior urethral regions (such as the membranous urethra and prostatic urethra) due to factors like trauma, inflammation, congenital developmental abnormalities, or iatrogenic injuries, which in turn causes voiding dysfunction. Among these, traumatic factors are the most common. For example, pelvic fractures, perineal straddle injuries, etc., can lead to urethral rupture or injury, with scar contracture forming during the healing process. In addition, iatrogenic injuries, such as prostate surgery or intraurethral procedures (e.g., urethral dilation, cystoscopy), may damage the urethral mucosa and trigger scar hyperplasia.
4. Female urethral stricture
Female urethral stricture is relatively rare and prone to missed diagnosis, often being confused with symptoms of other disorders causing dysuria. In females, 2-29% of patients presenting with refractory lower urinary tract symptoms (LUTS) have bladder outflow obstruction (BOO) of whom 4-20% will have a urethral stricture. True female urethral stricture therefore occurs in 0.08-5.4% of women with refractory LUTS. There is a markedly increased incidence in women over 64 years of age.
5. Hydronephrosis
Hydronephrosis is a condition of the urinary tract where one or both kidneys swell. This happens because pee (urine) doesn’t fully empty from your body. Symptoms may include sudden or intense pain in your back or side, vomiting, painful urination, blood in your pee, or weakness and fever due to a urinary tract infection. Hydronephrosis may lead to loss of kidney function or kidney failure. However, prompt treatment reduces the risk of long-term complications.
6.Ureteral stricture
Ureteral stricture refers to a condition where the lumen of the ureter narrows due to various causes, leading to obstruction of urine flow, which can trigger hydronephrosis and renal function impairment. Causes include congenital developmental abnormalities (such as ureteropelvic junction stricture), scar hyperplasia due to stones or inflammation, trauma, iatrogenic injuries (such as postoperative adhesions), tumor compression, or post-radiation fibrosis. Unilateral stricture may cause low back pain and hematuria; bilateral stricture may lead to oliguria or anuria, accompanied by fever and pyuria in case of secondary infection. For treatment, mild cases can be managed with balloon dilation or stent placement, while moderate to severe cases require individualized repair surgery.
7. Urinary fistula
The urinary fistula refers to an abnormal passage formed between organs around the urinary tract and the urinary system, characterized by urine leakage. Common types include vesicovaginal fistula, urethrovaginal fistula, ureterovaginal fistula, urethrorectal fistula, and urethroperineal fistula. Causes include obstetrical injuries, trauma, iatrogenic factors, and radiation-related damage. Urinary fistula is an extremely distressing traumatic condition. As urine cannot be controlled, surrounding organs are chronically soaked in urine, causing not only physical pain but also significant mental burden due to patients' fear of social interaction and inability to engage in productive labor. However, the vast majority of fistulas can be cured through surgical repair.