A urethral stricture is scarring in or around the urethra that narrows or blocks the passageway through which urine flows from the bladder. The stricture results from inflammation, infection or injury, and is much more common in men than in women. The scarring can occur anywhere between the bladder and the tip of the penis. In addition to uncomfortable urinary symptoms such as reduced flow rate and more frequent urination, a urethral stricture can lead to complications that include urinary tract infections, prostatitis, urinary retention and kidney damage.
Symptoms of urethral strictures are mostly urinary – painful urination, reduced urine output, slow urine stream, spraying of the stream, incomplete emptying of the bladder, and inability to void. Urinary tract infections are also common, and blood will occasionally appear in the urine. Additional symptoms include:
- Abdominal or pelvic pain
- Urethral discharge
- Swelling in the penile region
- Dark colored urine
Causes Of A Urethral Stricture
Typical causes of a urethral stricture include trauma, either from an injury, such as a car or bike accident, complications from a medical procedure such as a urethral catheter placement or from prostate surgery. Occasionally, an infection of the urethra or gonorrhea (a sexually transmitted disease) can cause this, but in many cases the cause of the stricture is unknown.
How Is A Urethral Stricture Diagnosed?
There are several tests used by urologists to diagnose a stricture:
- A cystoscopy involves examining the urethra using a special thin and flexible telescope.
- A flow test is an assessment of how much urine is passed per second. Flow rate is much reduced if a stricture is present.
- An x-ray may be taken while you pass urine to show the site and severity of the urethral stricture.
There are many options available depending on the size of the blockage and how much scar tissue is involved. Some treatments for a urethral stricture include:
- Dilation – enlarging the stricture with gradual stretching
- Urethrotomy – cutting the stricture with a laser or knife through a scope
- Open surgery – surgical removal of the stricture with reconnection and reconstruction, possibly with grafts (urethroplasty)
There are currently no available drugs to help treat strictures.
Typically, the overall prognosis of urethral stricture is very good and the most individuals can lead normal lives post treatment. You may need future treatments as well if the stricture is the result of scar tissue.