Urethral stricture: causes, symptoms and treatment
A weak urine stream and repeated infections may point to a narrowing of the urethra. Learn its causes, how it is diagnosed, and the treatment and reconstruction options.
The urethra is the tube that carries urine from the bladder out of the body. A urethral stricture is scar tissue that narrows this tube and obstructs the flow of urine; it is more common in men.
What causes a stricture?
- Pelvic injuries or direct injuries to the perineum.
- Procedures inside the urethra such as catheters or endoscopy, especially if repeated or prolonged.
- Chronic infection of the urethra and some inflammatory skin conditions affecting the penis.
- In some cases no clear cause is found.
What are the symptoms?
- A weak, interrupted or spraying urine stream.
- Needing to strain to pass urine and slow emptying of the bladder.
- A feeling that the bladder does not empty fully.
- Repeated urinary infections or pain when passing urine.
- In advanced cases, urinary retention (being unable to pass urine).
How is it diagnosed? By examination, measuring the urine flow rate, a urine test and an ultrasound scan, with contrast X-ray imaging of the urethra, and the doctor may use a urethroscope to define the position and length of the stricture.
Treatment options depend on the length and position of the stricture and on how many times it has been treated before:
- Dilatation or internal endoscopic incision of the stricture: suitable for some short strictures, but the stricture may come back, and repeating these procedures can increase scarring.
- Urethral reconstruction (urethroplasty): the narrowed segment is removed and the urethra is rebuilt with suitable tissue. For many patients this is the most durable long-term option, and it needs a surgeon who specialises in this type of surgery.
- A temporary catheter through the bladder wall for acute retention, until a treatment plan is made.
The doctor selects the right option for your case after an accurate diagnosis, and regular follow-up after treatment is advised so that any recurrence is detected early.
This is general health information. It does not replace seeing a doctor and having your own condition assessed.
