Urethral Stricture

Introduction

The male urethra is a fibromuscular tube that carries urine from the bladder, and semen from the ejaculatory ducts of the seminal vesicles and prostate gland, out of the body through the opening at the tip of penis.

A urethral stricture is a narrowing of any part of the urethra due to formation of scar tissue which limits the flow of urine and can result in medical problems of the urinary tract.

Causes

A urethral stricture may be caused due to:

• Trauma to the urethra or pelvis
• Insertion of an endoscope into the urethra for a medical procedure
• Use of a bladder catheter in the urethra to drain urine
• Prostate enlargement
• Surgical removal of the prostate gland
• Radiation therapy
• Sexually transmitted diseases

Signs and Symptoms

Signs and symptoms of a urethral stricture include:

• Slowing down of the urine stream
• Spraying of urine
• Incomplete emptying of the bladder
• Leakage of urine
• Straining or pain with urination
• Blood in the urine or semen
• Urinary tract infection (UTI)

Diagnosis

To diagnose a urethral stricture, your doctor will discuss your signs and symptoms, and perform a physical examination. Various diagnostic tests include:

• Measuring the rate of urine flow by having you urinate into a special collecting device.
• Bladder ultrasound to check for post-void residual urine volume.
• Retrograde urethrogram, which is a special X-ray procedure using contrast material to identify the urethral stricture.
• Cystoscopy, a procedure in which a flexible, lubricated tube-like instrument with a camera and light source is passed through the urethra to identify the urethral stricture.

Treatment

The various treatment options include:

• Urethral Dilation: During this procedure, the narrowed area of the urethra is widened using increasingly larger dilating instruments.
• Urethrotomy: During this procedure, a special cutting instrument or laser is used through a cystoscope to remove the scar tissue in the urethra causing the stricture.
• Urethral Reconstruction: This is an open surgery, in which the stricture is removed, and the cut ends of the urethra are sutured together or reattached with grafts.

Summary

Urethral strictures can be successfully treated to relieve symptoms and improve quality of life. However, the condition may occur again, and follow-up appointments after treatment should be kept as recommended to ensure a positive outcome.