The urology clinic at Mbarara Regional Referral Hospital is grappling with a growing backlog of patients suffering from urethral stricture, a condition that causes narrowing of the urethra and disrupts urine flow in men.
Dr. Marvin Mwesigwa, a urologist at the hospital, said the weekly clinic, held every Friday, attends to at least three new cases of urethral stricture. However, about 70 patients remain on the waiting list for treatment, many of whom are currently living with abdominal catheters.
Urethral stricture is often misdiagnosed as prostate-related conditions due to similar urinary symptoms, leading to delays in appropriate care. “Many men confuse urethral stricture with prostate enlargement or other causes of urinary obstruction and therefore seek the wrong treatment,” Mwesigwa said.
The condition is commonly caused by trauma, including injuries from road traffic crashes, falls, and sports. Damage to the urethra—particularly beneath the scrotum—can heal with scarring, leading to narrowing. Mwesigwa added that untreated sexually transmitted infections (STIs), especially gonorrhoea, can also result in urethral strictures, sometimes years after the initial infection.
Patients typically present with symptoms such as difficulty urinating, straining, frequent urination at night, incomplete bladder emptying, and associated pain. If left untreated, the condition can lead to acute urinary retention and, in severe cases, kidney failure.
Efforts are underway to address the backlog through international collaboration. Ryan Terlecki, working with colleagues including Caleb Covell and Brianna Goddard, is supporting the development of a training programme for urologists and general surgeons in Uganda to strengthen local capacity.
However, Terlecki cited persistent challenges, including limited resources and inadequate medical equipment, which continue to constrain the hospital’s ability to manage the condition effectively. He called for increased investment to improve access to specialised care.
Urology services at Mbarara Regional Referral Hospital also manage a range of conditions, including prostate cancer, benign prostate enlargement, urinary stones, and other diseases affecting the urinary and reproductive systems.
