Urethral Stricture

A urethral stricture is a narrowing of the urethra, which is the tube that carries urine from the bladder out of the body. This condition can cause difficulty urinating and other urinary problems.

Causes

Urethral strictures can be caused by a variety of factors, including:

• Trauma or injury to the urethra, such as from a car accident or a fall
• Infections, such as gonorrhea or other sexually transmitted infections
• Instrumentation, such as catheterization or cystoscopy
• Surgery, such as prostate surgery
• Cancer, such as urethral cancer
• Inflammation, such as from a condition called lichen sclerosus

Symptoms

The symptoms of a urethral stricture can vary depending on the severity of the narrowing. Common symptoms include:

• Difficulty starting to urinate
• Weak or interrupted urine flow
• Painful urination
• Frequent urination
• Urinary tract infections (UTIs)
• Blood in the urine

Diagnosis

A urethral stricture is typically diagnosed using a combination of physical examination, medical history, and diagnostic tests. These tests may include:

• Urinalysis: to check for blood, protein, or infection in the urine
• Uroflowmetry: to measure the flow rate of urine
• Post-void residual (PVR) measurement: to check for leftover urine in the bladder after urination
• Imaging studies, such as ultrasound or X-rays: to visualize the urethra and surrounding tissues
• Cystoscopy: to visually examine the inside of the urethra and bladder
• Urethrography: to take pictures of the urethra using a contrast agent

Treatment

The treatment for a urethral stricture depends on the severity and location of the narrowing. Treatment options may include:

• Dilation: to stretch the narrowed area of the urethra
• Urethrotomy: to surgically remove the scar tissue causing the narrowing
• Urethroplasty: to surgically reconstruct the urethra
• Stenting: to place a small tube in the urethra to keep it open
• Catheterization: to drain urine from the bladder when other treatments are not effective

Complications

If left untreated, a urethral stricture can lead to complications such as:

• Urinary tract infections (UTIs)
• Kidney damage
• Bladder damage
• Erectile dysfunction
• Infertility

Prevention

While not all urethral strictures can be prevented, there are steps that can be taken to reduce the risk of developing this condition. These include:

• Practicing safe sex to reduce the risk of sexually transmitted infections
• Avoiding instrumentation or catheterization whenever possible
• Seeking medical attention promptly if symptoms of a urethral stricture occur