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Urethral strictures occur when the urethra narrows due to scarring or inflammation, often caused by trauma or surgery. Symptoms include decreased urine output, pain, and swelling. Treatment options include urethral dilation or surgery. Recovery time is typically about a year.
A urethral stricture is a condition in which a scarred or inflamed urethra becomes too narrow to effectively remove urine from the body. Strictures can be caused by a number of factors, including infections, direct trauma, and surgical procedures. The condition most often affects men of reproductive age, although strictures are also occasionally seen in women and children. Most cases can be relieved by urologists through a procedure to manually expand the urethra with a medical balloon. Invasive surgery may be needed in severe strictures.
Trauma to the groin area and surgical procedures for other conditions are the most common causes of urethral stricture. Sexually transmitted infections, tumors, and congenital deformities can also lead to narrowing of the urethra. Strictures typically appear when scar tissue builds up in a small section of the urethra. The contraction usually occurs near the end of the penis or vaginal opening, although it is possible for a stricture to develop closer to the bladder. Rarely, most or all of the urethral tube may be compressed.
Symptoms of urethral stricture can vary based on the severity and exact location of the narrowing. Most people experience decreased urine output and frequent urges to urinate. An individual might have sharp pains when urinating or a dull, tight pain in the pelvic region and lower abdomen. The penis may swell and blood may be present in the urine and semen. An individual experiencing any possible symptoms of a urethral stricture should seek immediate medical attention to avoid potentially serious complications, such as kidney or bladder infections.
A urologist can usually diagnose a urethral stricture by inserting an instrument called a cytoscope into the urethral opening. A cytoscope is a small tube equipped with a camera that transmits images to a computer screen, allowing the doctor to locate the site of scarring and narrowing. Your urologist may decide to collect urine, semen, or tissue samples for laboratory analysis to check for viral or bacterial infections. After making an accurate diagnosis, your doctor can explain different treatment options.
The most common procedure to relieve a stricture is called a urethral dilation. The urologist inserts a balloon into the urethra and slowly inflates it, thus widening the walls of the tube. When the balloon is deflated and removed, the urethra generally retains its larger shape. A recurring stricture may require frequent dilations, performed in the urologist’s office or at home with a specialized kit provided by a doctor.
A urologist may decide that surgery is the best option for a long or severe stricture. A surgical specialist can usually fix a stricture by excising the scar tissue with a scalpel, being careful not to damage the surrounding tissue. A permanent stent may need to be placed in the urethra if the excision surgery is unsuccessful. Patients may need to use catheters for several days after surgery and participate in regular checkups with their urologists to monitor recovery. With treatment, most people experience full recoveries within about a year.
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