Urethral stricture disease is a fairly common condition that causes urinary problems, most often in men. If left untreated, it may progress and lead to infections in other parts of the urinary tract. The skilled urologists at Memorial Hermann provide exceptional patient care to diagnose and effectively treat urethral stricture.

What is a Urethral Stricture?

A narrowing of the urethra is called a urethral stricture. This is a common condition among men, but rarely occurs in women.

The urethra is the tube that transports urine from the bladder to be released out of the body. With a urethral stricture, scar tissue builds up in the urethra and limits the flow of urine out of the body. When men develop a urethral stricture, they may experience a slower urine stream and may need to strain to get urine out of their penis.

Without treatment, urethral stricture can lead to prostatitis (inflammation of the prostate) or urinary tract complications caused by a backup of urine. These complications may result in inflammation, infection and/or pain in the urinary tract.

There are two main types of urethral stricture:

Anterior urethral stricture

This is the most common type of stricture, and occurs in areas of the urethra that are closer to the penis.

Posterior urethral stricture

These strictures occur in the area of the urethra that is closest to the bladder. They are often caused by more serious pelvic injuries and may cause a more severe blockage.

Symptoms of Urethral Stricture

With a urethral stricture, you may experience some common symptoms:

  • Reduced amount of urine when urinating
  • Straining to urinate
  • Pain with urination
  • Urge to urinate more frequently
  • Inability to completely empty the bladder
  • Urinary tract infection
  • Prostatitis (inflammation of the prostate)

Seek immediate medical attention if you are unable to urinate at all. This is a sign of a severe urethral stricture that can cause serious problems with the bladder and kidneys.

Causes and Risk Factors of Urethral Stricture

Men are at a greater risk of developing urethral stricture because they have longer urethras than women, and urine must travel a greater distance to leave the body.

Urethral stricture is usually caused by chronic inflammation, an infection or an injury. Sometimes the cause is unknown. Scar tissue creates a narrowing of the urethra, and may be caused by:

  • Catheter use or other medical procedures that insert devices into the urethra
  • Injury or trauma to the urethra, penis, scrotum or pelvis
  • Sexually transmitted infections (STI)
  • Enlarged prostate

Diagnosis of Urethral Stricture

Having a reduced urine stream does not definitely diagnose a urethral stricture. More testing is needed to confirm the diagnosis. Weakened urine stream may also be caused by an enlarged prostate or bladder problems.

Your physician will evaluate your specific condition, and if a urethral stricture is suspected, they may recommend testing. This testing could include:

Retrograde urethrogram

A contrast agent is injected into the opening at the end of the penis. Then, an X-ray image is taken to determine if there is a urethral stricture.

Cystoscopy

Using a local anesthetic, your physician will insert a small device through the opening at the end of the penis. With a cystoscope, your physician can view the urethra to determine if there is a stricture.

Treatment for Urethral Stricture

The type of treatment will depend on the size and location of the urethral stricture, and the results of your imaging procedures.

Urethral dilation

Using either local or general anesthesia, your physician will use instruments to dilate (widen) the urethra. This process begins with smaller instruments and progresses to larger instruments until the desired widening is achieved. Urethral dilation is not always a permanent solution, and often needs to be repeated if the stricture returns.

Urethrotomy

Using general anesthesia, your physician will insert a cystoscope through the opening at the end of the penis to locate the stricture. Then, the scar tissue is cut to remove the blockage. Urethrotomy is not always a permanent solution, and often needs to be repeated if the stricture returns.

Urethroplasty

If the stricture is small, your physician may recommend starting with either urethral dilation or urethrotomy. If those procedures do not fix the problem, or if your stricture is severe, a urethroplasty may be a better option.

Urethroplasty is a procedure to reconstruct the urethra, and it is a more permanent solution to the problem than dilation or urethrotomy. In some cases with smaller strictures, the scar tissue is removed and the urethra is reconnected. When the stricture is more severe, the affected area of the urethra may need to be reconstructed using tissue from other parts of the body.

Scheduling an appointment

We are committed to using a multidisciplinary approach to provide exceptional urological care. Our highly skilled practitioners utilize leading-edge treatments for a full range health concerns.

Memorial Hermann-affiliated primary care physicians or urologists can diagnose urethral stricture disease and recommend the treatment option that is right for you. Find a doctor today.