ICD-10: N35.112

The ICD-10 code N35.112 refers specifically to a postinfective bulbous urethral stricture in males, categorized under the broader classification of urethral strictures. This condition is characterized by a narrowing of the urethra, which can occur as a result of previous infections, leading to complications in urinary flow.

Clinical Description

Definition

A bulbous urethral stricture is a type of urethral stricture that occurs in the bulbous portion of the urethra, which is located just below the prostate and above the penile urethra. The term "postinfective" indicates that the stricture has developed following an infection, which may include sexually transmitted infections (STIs) or other urinary tract infections (UTIs) that have caused inflammation and subsequent scarring of the urethral tissue.

Etiology

The primary cause of postinfective bulbous urethral stricture is the body's response to infection. Infections can lead to:
- Inflammation: The urethra becomes inflamed, which can cause tissue damage.
- Scarring: As the inflammation resolves, scar tissue may form, leading to a narrowing of the urethra.

Common infections that may lead to this condition include:
- Gonorrhea
- Chlamydia
- Other bacterial infections affecting the urinary tract

Symptoms

Patients with a bulbous urethral stricture may experience a variety of symptoms, including:
- Dysuria: Painful urination
- Urinary retention: Difficulty starting urination or a weak urine stream
- Frequent urination: Increased urgency and frequency of urination
- Hematuria: Blood in the urine, which may occur due to irritation or injury to the urethra

Diagnosis

Diagnosis typically involves:
- Medical history: Assessing previous infections and urinary symptoms.
- Physical examination: A thorough examination may reveal signs of stricture.
- Urethroscopy: A procedure that allows direct visualization of the urethra to assess the extent of the stricture.
- Imaging studies: Such as ultrasound or MRI, may be used to evaluate the urinary tract.

Treatment

Treatment options for postinfective bulbous urethral stricture may include:
- Urethral dilation: A procedure to widen the narrowed area.
- Urethrotomy: Surgical incision of the stricture to relieve obstruction.
- Urethroplasty: A more extensive surgical procedure that involves removing the stricture and reconstructing the urethra.

Conclusion

The ICD-10 code N35.112 is crucial for accurately documenting and coding cases of postinfective bulbous urethral stricture in males. Understanding the clinical implications, symptoms, and treatment options associated with this condition is essential for healthcare providers to ensure effective management and care for affected patients. Proper coding also facilitates appropriate reimbursement and tracking of healthcare outcomes related to this condition.

The ICD-10 code N35.112 refers to a specific condition known as "Postinfective bulbous urethral stricture, not elsewhere classified," which primarily affects males. This condition is characterized by a narrowing of the bulbous urethra, typically resulting from a previous infection. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Etiology

A bulbous urethral stricture is a narrowing of the urethra located in the bulbous region, which is the part of the urethra that is surrounded by the bulb of the penis. The "postinfective" designation indicates that the stricture has developed as a consequence of an infection, which may include sexually transmitted infections (STIs) such as gonorrhea or chlamydia, or other urinary tract infections (UTIs) that lead to inflammation and scarring of the urethra[1][2].

Patient Characteristics

• Demographics: This condition predominantly affects males, particularly those in their late teens to middle age, as they are more likely to experience STIs and related complications[3].
• Risk Factors: Risk factors include a history of urinary tract infections, sexually transmitted infections, prior urethral trauma, or surgical procedures involving the urethra. Additionally, conditions such as lichen sclerosus or other inflammatory diseases may predispose individuals to urethral strictures[4].

Signs and Symptoms

Common Symptoms

Patients with a bulbous urethral stricture may present with a variety of symptoms, including:

• Dysuria: Painful urination is a common complaint, often described as a burning sensation during urination[5].
• Urinary Frequency and Urgency: Patients may experience an increased need to urinate, often with a sense of urgency[6].
• Weak Urinary Stream: A noticeable decrease in the force of the urinary stream is frequently reported, which may lead to difficulty in initiating urination[7].
• Straining to Urinate: Patients may find themselves straining or pushing to initiate urination due to the obstruction caused by the stricture[8].
• Post-void Dribbling: Some individuals may experience dribbling of urine after urination has completed[9].
• Hematuria: Blood in the urine can occur, particularly if there is significant irritation or injury to the urethra[10].

Physical Examination Findings

During a physical examination, healthcare providers may note:

• Tenderness: There may be tenderness in the perineal area or along the urethra.
• Palpable Masses: In some cases, a palpable mass may be felt if there is significant scarring or inflammation.
• Signs of Infection: Evidence of systemic infection, such as fever or chills, may be present if the stricture is associated with an active infection[11].

Diagnosis and Management

Diagnostic Approaches

Diagnosis typically involves a combination of patient history, physical examination, and diagnostic tests, including:

• Uroflowmetry: This test measures the flow rate of urine and can help identify obstruction.
• Cystoscopy: A direct visualization of the urethra and bladder using a cystoscope can confirm the presence and extent of the stricture.
• Imaging Studies: Ultrasound or MRI may be used to assess the anatomy of the urethra and surrounding structures[12].

Treatment Options

Management of postinfective bulbous urethral stricture may include:

• Urethral Dilation: A non-surgical procedure to widen the stricture.
• Urethrotomy: Surgical incision of the stricture to relieve obstruction.
• Urethroplasty: A more extensive surgical procedure that involves excising the stricture and reconstructing the urethra[13].

Conclusion

Postinfective bulbous urethral stricture (ICD-10 code N35.112) is a significant condition that can lead to considerable discomfort and complications if left untreated. Understanding the clinical presentation, signs, symptoms, and patient characteristics is essential for healthcare providers to ensure timely diagnosis and appropriate management. Early intervention can significantly improve patient outcomes and quality of life.

For further information or specific case management, consulting urology specialists is recommended, as they can provide tailored treatment options based on individual patient needs.

ICD-10 code N35.112 refers specifically to a postinfective bulbous urethral stricture that is not classified elsewhere, particularly in males. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some relevant terms and descriptions associated with this diagnosis.

Alternative Names

1. Postinfective Urethral Stricture: This term emphasizes that the stricture is a result of a previous infection, which is a key aspect of the diagnosis.

2. Bulbous Urethral Stricture: This name highlights the specific anatomical location of the stricture, which occurs in the bulbous part of the urethra.

3. Male Urethral Stricture: A broader term that encompasses any stricture in the male urethra, including those caused by infections.

4. Urethral Stricture Disease: This term can be used to describe a range of conditions involving narrowing of the urethra, including postinfective cases.

5. Stricture of the Urethra: A general term that can refer to any narrowing of the urethra, not limited to postinfective causes.

Related Terms

1. Urethral Obstruction: This term refers to any blockage in the urethra, which can be caused by strictures, including those classified under N35.112.

2. Urethritis: While not synonymous, urethritis (inflammation of the urethra) can lead to strictures, making it a related term in the context of postinfective complications.

3. Fibrosis: This term may be relevant as postinfective strictures can involve fibrotic changes in the urethral tissue.

4. Urethral Reconstruction: A surgical procedure often considered for treating urethral strictures, including those classified under N35.112.

5. Chronic Urethral Stricture: This term may be used if the stricture persists over time, often as a result of previous infections.

Conclusion

Understanding the alternative names and related terms for ICD-10 code N35.112 is crucial for accurate medical coding, effective communication among healthcare providers, and appropriate patient management. These terms not only facilitate clearer documentation but also enhance the understanding of the condition's implications and treatment options. If you need further details or specific applications of these terms in clinical practice, feel free to ask!

The diagnosis of ICD-10 code N35.112, which refers to postinfective bulbous urethral stricture, not elsewhere classified, involves several clinical criteria and considerations. Understanding these criteria is essential for accurate diagnosis and appropriate coding in medical records.

Clinical Criteria for Diagnosis

1. Patient History

• Infection History: A detailed medical history should be taken to identify any previous urinary tract infections (UTIs) or sexually transmitted infections (STIs) that could lead to urethral strictures. Conditions such as gonorrhea or chlamydia may contribute to the development of strictures.
• Symptoms: Patients may report symptoms such as difficulty urinating, weak urine stream, or urinary retention, which are indicative of a potential stricture.

2. Physical Examination

• Genitourinary Examination: A thorough examination of the genital area may reveal signs of infection or structural abnormalities. The physician may assess for tenderness, swelling, or discharge.

3. Diagnostic Testing

• Urodynamic Studies: These tests measure the function of the bladder and urethra, helping to identify any obstruction caused by a stricture.
• Cystoscopy: This procedure involves inserting a thin tube with a camera into the urethra to visualize the urethra and bladder directly. It can confirm the presence of a stricture and assess its location and severity.
• Imaging Studies: Ultrasound or MRI may be used to evaluate the urinary tract and identify any abnormalities associated with the stricture.

4. Exclusion of Other Conditions

• It is crucial to rule out other potential causes of urethral obstruction, such as tumors, congenital abnormalities, or trauma. The diagnosis of N35.112 specifically pertains to strictures resulting from prior infections, so other causes must be excluded.

Coding Considerations

When coding for N35.112, it is important to ensure that:
- The diagnosis is supported by clinical findings and diagnostic tests.
- The stricture is specifically identified as postinfective, meaning it is a direct result of a previous infection.
- Documentation in the medical record clearly reflects the patient's history, examination findings, and results of any diagnostic tests performed.

Conclusion

The diagnosis of postinfective bulbous urethral stricture (ICD-10 code N35.112) requires a comprehensive approach that includes patient history, physical examination, and appropriate diagnostic testing. By adhering to these criteria, healthcare providers can ensure accurate diagnosis and coding, which is essential for effective treatment and reimbursement processes. Proper documentation and exclusion of other conditions are critical to support the diagnosis and facilitate appropriate management of the patient's condition.

When addressing the treatment of postinfective bulbous urethral stricture classified under ICD-10 code N35.112, it is essential to understand the nature of the condition and the standard treatment approaches available. Urethral strictures can significantly impact urinary function and quality of life, necessitating effective management strategies.

Understanding Postinfective Bulbous Urethral Stricture

Postinfective bulbous urethral stricture refers to a narrowing of the urethra in the bulbous region, typically resulting from previous infections, such as sexually transmitted infections or urinary tract infections. This condition can lead to symptoms such as difficulty urinating, urinary retention, and recurrent urinary tract infections. The management of this condition often requires a multifaceted approach, including both conservative and surgical options.

Standard Treatment Approaches

1. Conservative Management

In some cases, especially when the stricture is mild, conservative management may be appropriate. This can include:

• Observation: Monitoring the condition without immediate intervention, particularly if symptoms are mild.
• Urethral Dilation: A non-surgical procedure where a dilating instrument is used to widen the urethra. This can provide temporary relief but may need to be repeated over time.

2. Surgical Interventions

For more severe cases or when conservative measures fail, surgical options are typically considered:

• Urethrotomy: This procedure involves making an incision in the stricture to relieve the blockage. It is often performed under local or general anesthesia and can provide immediate relief.

• Urethroplasty: This is a more definitive surgical approach where the narrowed segment of the urethra is excised and reconstructed. Urethroplasty is considered the gold standard for treating urethral strictures, particularly in cases of recurrent strictures or when the stricture is long.

• Endoscopic Procedures: Techniques such as laser urethrotomy or balloon dilation can be performed endoscopically to treat strictures. These methods are less invasive and can be effective for certain types of strictures.

3. Postoperative Care and Follow-Up

After surgical intervention, careful follow-up is crucial to monitor for recurrence of the stricture. This may involve:

• Regular Urological Assessments: Follow-up visits to assess urinary function and detect any signs of recurrence.
• Urodynamic Studies: These tests can help evaluate how well the bladder and urethra are functioning post-treatment.

4. Adjunctive Therapies

In some cases, adjunctive therapies may be considered to enhance treatment outcomes:

• Antibiotic Therapy: If there is an underlying infection contributing to the stricture, appropriate antibiotic treatment is essential.
• Hydration and Lifestyle Modifications: Encouraging adequate fluid intake and lifestyle changes can help reduce the risk of urinary tract infections and support overall urinary health.

Conclusion

The management of postinfective bulbous urethral stricture (ICD-10 code N35.112) involves a combination of conservative and surgical approaches tailored to the severity of the condition and the patient's overall health. Urethroplasty remains the most effective long-term solution for significant strictures, while conservative measures may suffice for milder cases. Regular follow-up is essential to ensure successful outcomes and to monitor for any recurrence of the stricture. As always, treatment should be individualized based on the patient's specific circumstances and preferences.