Urethral stricture

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Urethral stricture
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Decreased urine stream, urinary retention, urinary tract infection
Complications	Bladder damage, kidney damage, urinary incontinence
Onset	Any age, more common in males
Duration	Chronic
Types	N/A
Causes	Injury, infection, surgery, catheterization
Risks	Trauma, sexually transmitted infections, prostate surgery
Diagnosis	Cystoscopy, retrograde urethrogram, urine flow test
Differential diagnosis	Benign prostatic hyperplasia, urethral cancer, urinary tract infection
Prevention	N/A
Treatment	Urethral dilation, urethrotomy, urethroplasty
Medication	Antibiotics for infection
Prognosis	Variable, depends on severity and treatment
Frequency	More common in males, rare in females
Deaths	N/A

Narrowing of the lumen of the urethra.

Causes of urethral stricture

• Scar tissue from surgery.
• Infection
• Injury
• Tumor

Other factors

• Sexually transmitted infection (STI)
• Urethral catheter or cystoscope
• Benign prostatic hyperplasia (BPH)
• Injury to the pelvic area
• Repeated urethritis

Symptoms

• Blood in the semen
• Discharge from the urethra
• Bloody or dark urine
• Strong urge to urinate and frequent urination
• Inability to empty bladder (urinary retention)
• Painful urination or difficulty urinating
• Loss of bladder control
• Increased frequency or urgency to urinate
• Pain in the lower abdomen and pelvic area
• Slow urine stream (may develop suddenly or gradually) or spraying of urine
• Swelling of the penis

Anatomical chart of the genitourinary system

Physical examination

• A physical exam may show the following:
• Decreased urinary stream
• Discharge from the urethra
• Enlarged bladder
• Enlarged or tender lymph nodes in the groin
• Enlarged or tender prostate
• Hardness on the under surface of the penis
• Redness or swelling of the penis
• Sometimes, the exam reveals no abnormalities.

Investigations

• Cystoscopy
• Postvoid residual (PVR) volume
• Retrograde urethrogram
• Tests for chlamydia and gonorrhea
• Urinalysis
• Urinary flow rate
• Urine culture

Treatment

• The urethra may be dilated during cystoscopy.
• An open urethroplasty may be done for longer strictures.
• 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.

Prognosis

• The outcome is often excellent with treatment.
• Urethral stricture may totally block urine flow.

Prevention

• Practicing safer sex may decrease the risk of getting STIs and urethral stricture.
• Treating urethral stricture quickly may prevent kidney or bladder complications.