Urethral stricture is an abnormal narrowing of the urethra. The urethra is the tube that carries urine out of the body from the bladder.
A urethral stricture may be caused by swelling or scar tissue from surgery. It can also occur after an infection or injury. Rarely, it may be caused by pressure from a growing tumor near the urethra.
Other factors that increase the risk for this condition include:
Strictures that are present at birth (congenital) are rare. The condition is also rare in women.
A physical exam may show the following:
Sometimes, the exam reveals no abnormalities.
Tests include the following:
The urethra may be widened (dilated) during cystoscopy. Topical numbing medicine will be applied to the area before the procedure. A thin instrument is inserted into the urethra to stretch it. You may be able to treat your stricture by learning to dilate the urethra at home.
If urethral dilation cannot correct the condition, you may need surgery. The type of surgery will depend on the location and length of the stricture. If the narrowed area is short and not near the muscles that control the exit from the bladder, the stricture may be cut or dilated. One procedure uses a drug-coated balloon, which is inserted and opened up to dilate the urethra and deliver the medicine to the area. After several minutes, the balloon is deflated and removed. The medicine helps the stricture remain open.
A surgery called an open urethroplasty may be done for longer strictures. This surgery involves removing the diseased area. The urethra is then rebuilt. The results vary, depending on the size and location of the stricture, the number of treatments you have had, and the surgeon's experience.
In acute cases when you cannot pass urine, a suprapubic catheter may be placed. This is an emergency treatment. This allows the bladder to drain through the abdomen.
There are currently no drug treatments for this disease. If no other treatments work, a urinary diversion called an appendicovesicostomy (Mitrofanoff procedure) or another type of surgery may be done. This lets you drain your bladder through the wall of the abdomen using a catheter or a stoma bag.
The outcome is often excellent with treatment. Sometimes, treatment needs to be repeated to remove scar tissue.
A urethral stricture may totally block urine flow. This can cause sudden urinary retention. This condition must be treated quickly. Long-term blockage can lead to permanent bladder or kidney damage.
Contact your health care provider if you have symptoms of urethral stricture.
Practicing safer sex may decrease the risk of getting STIs that may cause a urethral stricture.
Treating urethral stricture quickly may prevent kidney or bladder complications.
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Virasoro R, Jordan GH, McCammon KA. Surgery for benign disorders of the penis and urethra. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 82.
Wessells H, Morey A, Souter L, Rahimi L, Vanni A. Urethral stricture disease guideline amendment (2023). J Urol. 2023;210(1):64-71.Epub 2023 Apr 25. PMID: 37096574. pubmed.ncbi.nlm.nih.gov/37096574/.BACK TO TOP
Review Date: 7/4/2022
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/20/2023.
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