What you need to know about Urethral Stricture

By Kristi Hebert, M.D.

The urethra is the tube that urine exits through when it leaves the bladder. A stricture occurs when a segment of that tube develops scar tissue and becomes narrow. This narrowing can affect how well the bladder functions to drain the urine.

Symptoms:

  • slow or weak urinary stream
  • difficulty urinating/straining
  • incomplete bladder emptying
  • urinary tract infections
  • frequent urination
  • blood in the urine

Occasionally, the symptoms can be severe enough to prevent any urine from exiting the bladder, prompting patients to visit an emergency room.

Causes:

Many times the cause remains unknown. However, there are some risk factors known to be associated with stricture development. These include a history of:

  • direct trauma (such as a bike straddling accident or being kicked in the scrotal area)
  • previous catheter use
  • previous surgical procedures on the bladder or prostate
  • prostate radiation therapy
  • some sexually transmitted infections

It is very common for symptoms to develop many years after the causative event.

Diagnosis:

To diagnose a urethral stricture, a small flexible camera is inserted into the urethra to visualize along its course. The camera is used to identify both the location of the stricture and how narrow it is. Imaging studies (x-rays) can then determine the length of the narrowing. All of this information is used to plan the proper treatment.

Treatment:

Once a stricture is diagnosed and assessed, surgery can be used to treat the problem. Reconstruction of the urethra can be performed by removing the narrow segment and connecting the healthy portions of the tube back together, or by transferring tissue from elsewhere in the body to the urethra in order to make it wider. Most commonly, this tissue is taken from the inner lining of the cheeks.

Strictures can also be managed with internal cutting or dilating in some cases. These procedures widely differ from reconstruction regarding the expected success rates. Occasionally, patients may choose to insert a catheter in the bladder instead of pursuing surgery.

If you believe you may be suffering from a urethral stricture, contact Georgia Urology at 404-252-8227 to schedule a consultation.