Urethral Strictures

Overview and Facts about Urethral Strictures

A urethral stricture results when scar tissue narrows the urethra, which is the tube that carries urine from the bladder out of the body.

This scar tissue slows the flow of urine and leads to other medical problems, including an increased risk for infection or inflammation.

Signs and Symptoms of Urethral Strictures

Common signs and symptoms of this urology condition include:

• Reduced urine output
• Inability to empty the bladder completely
• Urine spray instead of stream
• Pain or straining during urination
• Frequent urges to urinate
• Repeated urinary tract infections (UTIs)
• Inability to urinate (complete urinary retention)

Tests and Diagnosis of Urethral Strictures

Doctors diagnose urethral strictures after reviewing a patient’s medical history, performing a physical examination, a urinalysis, and also studying the results of imaging tests.

The imaging tests that help the doctor determine the exact location and size of the stricture include:

• Ultrasound
• Retrograde urethrogram
• Cystography, filling, and voiding (VCUG)
• Antegrade cystourethrogram
• Cystourethroscopy
• MRI
• CT scan

In order to find the underlying cause of the urethral stricture, the doctor may request a urine or urethral culture to test for STDs such as gonorrhea or chlamydia, a prostate exam, or a prostate cancer screening.

Treatment and Care for Urethral Strictures

Urethral strictures will not go away on their own and medications may have limited effects. In most cases, doctors recommend surgery for those who experience uncomfortable symptoms, especially if the patient experiences:

• Difficulty urinating
• Urinary retention
• Bladder stones
• Recurrent UTIs
• Increasing amount of urine left in the bladder
• No relief from more conservative measures

Depending on the severity and location of the stricture, a doctor may opt for different surgical techniques like:

• Urethroplasty — This procedure involves using a traditional surgical approach with open incisions. The doctor removes the damaged section of the urethra and replaces it with a graft from your own body, which is often taken from the mouth.

In certain situations, gentle stretching of the urethra of endoscopic cutting of a stricture will relieve the blockage.

Causes and Risk Factors of Urethral Strictures

Urethral strictures can develop from different causes. Some of the most commonly seen include:

• Damage to the urethra caused by injury, trauma, surgery, or infection
• Inflammation from medical procedures that insert an instrument into the urethra
• Long-term use of catheters for urine elimination
• An enlarged prostate
• Cancer of the prostate or urethra
• Radiation therapy
• Certain sexually transmitted diseases (STDs)

Urethral strictures are much more common in men and are rare in women.