ICD-10: N35.114

The ICD-10 code N35.114 refers specifically to a postinfective anterior urethral stricture in males that is not classified elsewhere. This condition is characterized by a narrowing of the anterior urethra, which is the part of the urethra that runs through the penis, following an infection. Below is a detailed clinical description and relevant information regarding this diagnosis.

Clinical Description

Definition

A urethral stricture is a condition where the urethra becomes narrowed, which can impede the flow of urine. The term "postinfective" indicates that the stricture has developed as a result of a previous infection, which may have caused inflammation and subsequent scarring in the urethral tissue.

Etiology

The most common causes of anterior urethral strictures include:
- Infections: Sexually transmitted infections (STIs) such as gonorrhea or chlamydia can lead to urethritis, which may result in scarring.
- Trauma: Injury to the urethra, whether from external forces or medical procedures, can also lead to strictures.
- Inflammatory conditions: Conditions such as lichen sclerosus can cause chronic inflammation and scarring.

Symptoms

Patients with anterior urethral strictures may experience a variety of symptoms, including:
- Dysuria: Painful urination.
- Urinary frequency: Increased need to urinate.
- Weak urine stream: Difficulty in initiating urination or a reduced flow of urine.
- Straining: Increased effort required to urinate.
- Urinary retention: In severe cases, the inability to urinate may occur.

Diagnosis

Diagnosis typically involves:
- Medical history: Assessing previous infections or trauma.
- Physical examination: A thorough examination may reveal signs of stricture.
- Urethroscopy: A procedure that allows direct visualization of the urethra.
- Imaging studies: Such as retrograde urethrogram (RUG) to assess the location and extent of the stricture.

Treatment

Management of postinfective anterior urethral stricture may include:
- Dilation: A procedure to widen the stricture.
- 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 N35.114 is crucial for accurately documenting and coding cases of postinfective anterior urethral stricture in males. Understanding the clinical implications, symptoms, and treatment options is essential for healthcare providers to manage this condition effectively. Proper coding ensures that patients receive appropriate care and that healthcare providers can track and analyze treatment outcomes related to this diagnosis.

Postinfective anterior urethral stricture, classified under ICD-10 code N35.114, is a condition that arises following an infection in the urethra, leading to a narrowing of the anterior urethra. This condition is particularly relevant in males, as it can significantly impact urinary function and quality of life. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with this condition.

Clinical Presentation

Definition and Etiology

Postinfective anterior urethral stricture refers to the scarring and narrowing of the anterior urethra that occurs as a result of previous infections, such as sexually transmitted infections (STIs) or urinary tract infections (UTIs). Common pathogens include Neisseria gonorrhoeae and Chlamydia trachomatis, which can lead to urethritis and subsequent stricture formation due to inflammation and fibrosis[1][2].

Patient Characteristics

• Demographics: This condition predominantly affects males, particularly those in their late teens to early 50s, as they are more likely to experience STIs and related urethral infections[3].
• Risk Factors: Key risk factors include a history of STIs, recurrent urinary tract infections, previous urethral trauma (e.g., catheterization or surgical procedures), and certain lifestyle factors such as unprotected sexual practices[4].

Signs and Symptoms

Common Symptoms

Patients with postinfective anterior urethral stricture may present with a variety of symptoms, which can vary in severity:

• 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 notable sign of urethral stricture is a reduced caliber of the urinary stream, which may be intermittent or weak[7].
• Straining to Urinate: Patients may find themselves having to exert more effort to initiate urination due to the obstruction caused by the stricture[8].
• Post-void Dribbling: Some individuals may experience dribbling of urine after completing urination, which can be frustrating and embarrassing[9].
• Hematuria: Blood in the urine may occur, particularly if there is significant irritation or injury to the urethra[10].

Physical Examination Findings

During a physical examination, healthcare providers may observe:

• Tenderness: There may be tenderness in the lower abdomen or perineal area upon palpation.
• Urethral Discharge: In cases where an active infection is present, there may be purulent or mucous discharge from the urethra[11].
• Signs of Infection: Fever or systemic signs of infection may be present if the stricture is associated with an ongoing infectious process[12].

Conclusion

Postinfective anterior urethral stricture is a significant condition that can lead to various urinary symptoms and complications in males. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for timely diagnosis and management. Early intervention can help alleviate symptoms and prevent further complications, such as urinary retention or bladder damage. If you suspect you or someone you know may be experiencing these symptoms, it is essential to seek medical evaluation for appropriate diagnosis and treatment options.

The ICD-10 code N35.114 refers specifically to "Postinfective anterior urethral stricture, not elsewhere classified, male." This code is part of a broader classification system used for diagnosing and coding various medical conditions. Below are alternative names and related terms associated with this specific diagnosis.

Alternative Names

1. Postinfective Urethral Stricture: This term emphasizes the condition's origin due to a previous infection.
2. Anterior Urethral Stricture: This highlights the location of the stricture within the urethra, specifically the anterior section.
3. Male Urethral Stricture: A general term that indicates the condition occurs in males, which is relevant for this specific code.

Related Terms

1. Urethral Stricture: A broader term that encompasses any narrowing of the urethra, which can be caused by various factors, including infections, trauma, or surgery.
2. Urethral Obstruction: This term refers to any blockage in the urethra, which may include strictures as a cause.
3. Postinfective Complications: This term can refer to complications arising from infections that may lead to conditions like urethral strictures.
4. Stricture Disease: A term that may be used to describe a condition characterized by the presence of strictures in the urethra.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and coding conditions accurately. The specificity of the ICD-10 code N35.114 helps in identifying the exact nature of the stricture, which is essential for treatment planning and insurance reimbursement.

In summary, the ICD-10 code N35.114 is associated with various alternative names and related terms that reflect its clinical significance and the anatomical focus of the condition. These terms are vital for effective communication among healthcare providers and for accurate medical documentation.

To diagnose ICD-10 code N35.114, which refers to postinfective anterior urethral stricture, not elsewhere classified, in males, healthcare providers typically follow a set of clinical criteria and diagnostic procedures. Here’s a detailed overview of the criteria and processes involved in diagnosing this condition.

Understanding Anterior Urethral Stricture

Anterior urethral stricture is a narrowing of the urethra that can occur due to various causes, including infections, trauma, or inflammatory conditions. In the case of N35.114, the stricture is specifically postinfective, meaning it develops as a complication following an infection.

Diagnostic Criteria

1. Clinical History

• Infection History: A detailed medical history is essential, focusing on any previous urinary tract infections (UTIs), sexually transmitted infections (STIs), or other infections that could lead to urethral scarring.
• Symptoms: Patients may report symptoms such as:
  • Difficulty urinating (dysuria)
  • Weak urine stream
  • Urinary frequency or urgency
  • Pain during urination
  • Possible blood in urine (hematuria)

2. Physical Examination

• A thorough physical examination, including a genital examination, may reveal signs of infection or scarring.
• Assessment of the prostate may also be performed, as prostate issues can contribute to urinary symptoms.

3. Urodynamic Studies

• These tests measure how well the bladder and urethra are functioning. They can help identify any obstruction caused by the stricture.

4. Imaging Studies

• Ultrasound: A pelvic ultrasound may be used to visualize the urinary tract and assess for any abnormalities.
• Retrograde Urethrogram (RUG): This imaging technique involves injecting contrast dye into the urethra to visualize the stricture and determine its location and length.
• Voiding Cystourethrogram (VCUG): This test evaluates the bladder and urethra during urination, helping to identify any obstructions.

5. Cystoscopy

• A cystoscope (a thin tube with a camera) is inserted into the urethra to directly visualize the stricture. This procedure allows for assessment of the severity and extent of the stricture.

6. Biopsy (if necessary)

• In some cases, a biopsy may be performed to rule out malignancy or other underlying conditions, especially if there are atypical findings during cystoscopy.

Conclusion

The diagnosis of postinfective anterior urethral stricture (ICD-10 code N35.114) involves a comprehensive approach that includes a detailed patient history, physical examination, and various diagnostic tests such as imaging studies and cystoscopy. By following these criteria, healthcare providers can accurately diagnose the condition and determine the appropriate treatment plan. If you have further questions or need more specific information, feel free to ask!

Postinfective anterior urethral stricture, classified under ICD-10 code N35.114, is a condition that arises following an infection, leading to the narrowing of the urethra in males. This condition can significantly impact urinary function and quality of life. The treatment approaches for this type of stricture are varied and depend on the severity of the stricture, the patient's overall health, and the presence of any underlying conditions.

Standard Treatment Approaches

1. Conservative Management

In cases where the stricture is mild and not causing significant symptoms, conservative management may be appropriate. This can include:

• Observation: Monitoring the condition without immediate intervention, especially if the patient is asymptomatic.
• Urethral Dilation: A non-surgical procedure where a doctor gradually dilates the urethra using progressively larger instruments. This can provide temporary relief but may need to be repeated.

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 narrowing. It is often performed under local or general anesthesia and can be effective for shorter strictures.

• Urethroplasty: This is a more definitive surgical approach where the narrowed segment of the urethra is excised and reconstructed. Urethroplasty is generally preferred for longer strictures and has a higher success rate compared to urethrotomy, especially in recurrent cases.

3. Endoscopic Techniques

Endoscopic procedures can also be utilized, particularly for diagnosis and treatment:

• Optical Urethrotomy: Similar to urethrotomy but performed using an endoscope, allowing for direct visualization of the stricture. This method is less invasive and can be done on an outpatient basis.

4. Postoperative Care and Follow-Up

Regardless of the treatment approach, postoperative care is crucial:

• Monitoring for Recurrence: Regular follow-up appointments are necessary to monitor for any signs of recurrence of the stricture.
• Urodynamic Studies: These may be performed to assess urinary function and the effectiveness of the treatment.

5. Adjunctive Therapies

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

• Antibiotic Therapy: If there is an underlying infection contributing to the stricture, appropriate antibiotic treatment is essential.
• Catheterization: In cases of acute urinary retention, temporary catheterization may be necessary until definitive treatment can be performed.

Conclusion

The management of postinfective anterior urethral stricture (ICD-10 code N35.114) involves a range of treatment options from conservative measures to surgical interventions. The choice of treatment should be individualized based on the patient's specific circumstances, including the severity of the stricture and the presence of any complications. Regular follow-up is essential to ensure the effectiveness of the treatment and to monitor for any recurrence of the stricture.