Urethral Strictures

What causes Urethral Strictures?

Urethral strictures are scars that form after procedures involving the urethra, bladder, or prostate. Strictures also may occur after trauma, chronic inflammation, or prior radiation. In some instances, a cause is never determined.

What are the symptoms of Urethral Strictures?

You may experience the following symptoms:

• Trouble starting your urine stream
• Weak or split urine stream
• Urine flow is interrupted
• Burning when you urinate
• Difficulty emptying your bladder
• Recurrent UTIs
• Pain in your penis

How are Urethral Strictures diagnosed?

During your visit, your doctor will ask about your medical history and will perform an exam of your abdomen and genitalia.

Information regarding prior procedures on the urethra, bladder, or prostate is important.

Tests that may be performed during or after your visit:

• Urinalysis: Evaluates for any blood in the urine or infection.
• Post-void residual: You’ll be asked to urinate, then be checked to make sure you are emptying your bladder.
• Uroflow test: You’ll urinate in a funnel to measure the strength of your urine stream.
• Cystoscopy: A small scope is inserted into the urethra. In men, the opening is at the end of your penis. In women, it’s just above your vagina. The test looks for scar tissue and evaluates the urinary sphincter muscle.
• Retrograde urethrogram: During this test for men, a small tube is inserted into the tip of the penis and contrast dye is instilled into the urethra. X-rays are then performed to take a picture of the degree and length of the stricture. Afterwards you may be asked to urinate while additional x-rays are taken.

How are Urethral Strictures treated?

Surgical treatments:

• Urethral dilation: This can be performed either in the office or an operating room. This is a minimally invasive procedure where the scar tissue is moved out of the way by stretching the urethra.
• Incision of urethral stricture: This is performed in the operating room and is a minimally invasive procedure where the scar tissue is cut by an instrument inserted through a cystoscope.
• Urethroplasty: This is a surgical procedure typically performed by a fellowship-trained reconstructive surgeon involving surgical removal of the scar tissue and reconstruction of the urethra. It is possible tissue from the inside of the mouth will be needed to help in repairing the urethra. These surgeries have the highest rate of long-term success.