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Urethral Strictures

The urethra is the tube that carries urine from the bladder (through the penis in males) to the outside of the body. A urethral stricture can occur anywhere in the urethra. A urethral stricture is a scarred area that causes narrowing of the caliber of the urethra. The stricture eventually reduces or obstructs the flow of urine out of the bladder, making it difficult to urinate. The bladder therefore must work harder to push the urine through the narrowed area of the urethra (the stricture).

There are many causes of urethral strictures:

If a urethral stricture is not treated appropriately, the increased strain on the bladder can damage and weaken the bladder muscle. This can lead to a number of serious health problems such as urinary retention (inability to pass urine), urinary incontinence (leakage of urine), inflammation or infection of the urinary tract, reflux (urine backs up into the kidneys), and kidney failure.

Symptoms and Signs:
Symptoms and signs of a urethral stricture may include a weak or slow urine stream, hesitation or trouble starting urination, taking a long time to urinate and empty the bladder, a sense of incomplete emptying, dribbling, urgency, irritation or burning during urination, urinary frequency, or urinary retention. Sometimes one may intermittently or continuously leak urine because the bladder is full beyond its capacity and overflow incontinence occurs. Sometimes a urethral stricture is diagnosed when a healthcare provider cannot insert a catheter through the urethra into the bladder.

Evaluation:
Evaluation of men with urethral injury or with a known or suspected urethral stricture may include a combination of:

It is very important to have an accurate diagnosis and evaluation of the length and location of a urethral stricture. Once a urethral stricture is diagnosed, your urologist will determine any further evaluation that is needed. Options for treatment will be presented and discussed with you.

Several treatment options are available for men with urethral strictures. Some urethral strictures can be managed using a single procedure. If a stricture returns after one or more treatments, it is called a recurrent stricture. Without appropriate treatment, a stricture will recur almost 100% of the time. Strategies for prevention of a recurrent stricture will also be discussed with you.

Temporary Management:
Temporary management options for urethral strictures include:

Treatment Options
Treatment options for urethral strictures include:

Long-term Follow-up
After the urethral stricture has been treated, frequent follow-up exams will be needed during the first year and then periodically thereafter to ensure that the stricture does not recur.


 UMHS Department of Urology, November 2008