What are urethral strictures?

A urethral stricture is a narrowing in the urethra – the tube that carries urine and sperm through the penis to outside the body.

What are the causes?

The constriction of the urethra is usually caused by tissue inflammation or the presence of scar tissue. A straddle injury is a common trauma to that can lead to urethral stricture and examples include falling onto a bicycle bar or getting hit in the area close to the scrotum. Men with penile implants, and young boys who have had hypospadias surgery to address an underdeveloped urethra, have a higher chance of developing urethral stricture.

Other common causes of urethral stricture include:

• Benign Prostatic Hyperplasia
• pelvic fractures
• radiation
• catheter insertion
• surgery performed on the prostate

Far less common causes include:

• a tumor located close to the urethra
• gonorrhea or chlamydia (sexually transmitted diseases)
• untreated or repetitive urinary tract infection

What are the symptoms?

Urethral strictures can cause numerous symptoms, ranging from mild to severe. Some of the signs are:

• weak urine flow, or a decrease in volume of urine
• frequent, sudden urges to urinate
• frequent starting and stopping of urinary stream
• a feeling of incomplete bladder emptying after urination
• burning or pain during urination
• incontinence
• penile swelling and pain
• pain in the pelvic area or lower abdominal area
• darkening of the urine
• blood in the semen or urine
• urethral discharge
• inability to urinate (this is very serious and you should seek immediate medical attention)

How is it diagnosed?

Diagnosis is done with a flow test and flexible cystoscopy (a thin, tube-like device with a lens attached)

How is it treated?

In some cases, widening the stricture with special dilators, or using a laser to cut it may be recommended. In the case of severe strictures, an open urethroplasty surgical procedure involves removing affected tissue and reconstructing the urethra.