STRICTURE (Lat. stricture, from stringere, to draw tight). A contraction in the calibre of one of the mucous-membr•nue-lined tubular struc tures of the body, such as the urethra, the rectum, the (esophagus. or the larynx. The most common form of stricture and the variety gen erally referred to when the term stricture is used alone is stricture of the urethra. Three' varieties of stricture of theeurethral canal are recognized: ( 1 ) spasmodic ; ( 2 ) inflammatory ; and ( 3 ) organic. The first form is due simply to reflex muscular contraction caused by irritation of some portion of the urethra, as from an ulcer ating spot or a sensitive organic stricture. The second form is due to simple inflammatory swell ing of sonic portion of the urethral tract, such as occurs in acute gonorrhea or after the internal administration of such drugs as cantharides and turpentine. The third, and by far the most fre quent and important variety of stricture, is caused by permanent changes in the tissues of the urethra and those surrounding it. These changes usually consist either in inflammatory thickening of the urethral wall and periurethral tissues or else in actual cieatrization and narrowing of the channel from the accompanying contraction; or both of these conditions may be present at the same time. The initial causes in bringing these
changes about are chronic inflammation (gunor Hera) or injuries by caustic o• irritant sub stances.
The results of stricture of the urethra if al lowed to persist are often far-reaching and dis astrous. The bladder, ureters, and kidneys may finally in turn become the scat of disease from the continued retention of urine unable to find free and regular exit through the natural outlet, or rupture of the urethra from prolonged re tention, allowing extravasation of urine into the surrounding tissues, with death resulting from uramic poisoning.
The treatment of organic stricture of the ure thra is mainly mechanical. It consists in di latation of the contracted area by means of sounds or bougies, and where this method is in applicable divulsion of the stricture by means of suitable cutting instruments is indicated. After division of the stricture the lumen of the urethra is kept open to the proper degree by the subsequent periodic passage of a sound. Consult Dennis, American Text-Book of Surgery (Phila delphia. '1802 ) .