Is Urethral Stricture?
The urethra is
a tube that carries urine from the bladder so it can be expelled from the body.
Usually the urethra is wide enough for urine to flow freely
through it. When the urethra narrows, it can restrict urinary flow. This is known
as a urethral stricture.
Urethral stricture is a medical condition that mainly affects men.
Are the Causes of Urethral Stricture?
Urethral stricture involves constriction of the urethra. This is
usually due to tissue inflammation or the presence of scar tissue. Scar tissue
can be a result of many factors. Young boys who have hypospadias surgery (a
procedure to correct an underdeveloped urethra) and men who have penile
implants have higher chances to develop urethral strictures.
A straddle injury is a common type of trauma that can lead to
urethral stricture. Examples of straddle injuries include falling on a bicycle
bar or getting hit in the area close to the scrotum.
Other possible causes of urethral stricture include:
- pelvic fractures
- catheter insertion
- surgery performed on the prostate
Rarer causes include:
- a tumor located in close proximity to the
- untreated or repetitive urinary tract infections
- the sexually transmitted infections (STIs)
gonorrhea or chlamydia
Are the Risk Factors for Urethral Stricture?
Some men have an elevated risk of developing urethral stricture,
especially those who have:
- had one or more STIs
- had recent catheter (a small, flexible tube
inserted into the body to drain urine from the bladder) placement
- had urethritis (swelling and irritation in the
urethra), possibly due to infection
- an enlarged prostate
Are the Symptoms of Urethral Stricture?
Urethral stricture can cause numerous symptoms, which range from
mild to severe. Some of the signs of a urethral stricture include:
- weak urine flow or reduction in the volume of
- sudden, frequent urges to urinate
- pain or burning during urination
- inability to control urination (incontinence)
- pain in the pelvic or lower abdominal area
- urethral discharge
- penile swelling and pain
- presence of blood in the semen or urine
- darkening of the urine
- inability to urinate (very serious — requires
immediate medical attention)
Is Urethral Stricture Diagnosed?
Doctors may use several approaches to diagnose urethral stricture.
Reviewing Your Symptoms and Medical History
You can self-report the symptoms mentioned above. Your doctor may
also ask about past illnesses and medical procedures to determine whether one
or more risk factors are present.
Performing a Physical Examination
A simple physical examination of the penis area can help the
doctor identify issues that indicate the presence of a urinary stricture. For
instance, the doctor will be able to readily observe redness (or urethral
discharge) and find out if one or more areas are hard or swollen.
To make a definite diagnosis of a urethral stricture, the doctor
may also decide to perform one or more of the following tests:
- measuring the rate of flow during urination
- analyzing the physical and chemical properties
of urine to determine if bacteria (or blood) are present
- cystoscopy: inserting a small tube with a camera
into the body to view the inside of the bladder and urethra (This is the most
direct way to check for stricture.)
- measuring the size of the urethral opening
- tests for chlamydia and gonorrhea
Are the Treatment Methods for Urethral Stricture?
Treatment depends on the severity of the condition.
The primary mode of treatment is to make the urethra wider using
a medical instrument called a dilator. This is an outpatient procedure, meaning
you won’t have to spend the night at the hospital. A doctor will begin by
passing a small wire through the urethra and into the bladder to begin to
dilate it. Over time, larger dilators will gradually increase the width of the
Another nonsurgical option is permanent urinary catheter
placement. This procedure is usually an option for severe cases. It carries
risks such as bladder irritation and urinary tract infections.
Surgery is another option. An open urethroplasty is an option for longer, more severe
strictures. This procedure involves removing affected tissue and reconstructing
the urethra. Results vary based on the stricture size.
Urine Flow Diversion
A catheter in the abdomen may need to divert and drain urine flow.
This is very rare, and considered a last-resort method.
Can I Prevent Urethral Stricture?
It’s not always possible to prevent urethral stricture. Since STIs
are one cause, using protection during sexual contact can prevent some cases.
However, injuries and other medical conditions associated with urethral
stricture can’t always be avoided.
It’s important to see a doctor right away if you’re experiencing
symptoms of urethral stricture. Treating the problem quickly is the best way to
avoid serious complications.
Is the Long-Term Outlook?
Many people have a good outcome after treatment for a urethral
stricture. You may need future treatments as well if the stricture is the
result of scar tissue.
In some cases, stricture can cause urinary retention, the inability
to urinate due to complete blockage in the urethra. This is a potentially
dangerous condition. You should call your doctor right away if you experience
symptoms of stricture and become unable to urinate.