Urethral stricture

Main Navigation

•	Encyclopedia Home
•	Diseases A-Z

Images

Female urinary t...

Male urinary tra...

Definition

Urethral stricture is an abnormal narrowing of the tube that carries urine out of the body from the bladder (urethra).

Causes

Urethral stricture may be caused by inflammation or scar tissue from surgery, disease, or injury. It may also be caused by pressure from an enlarging tumor near the urethra, although this is rare.

Other risks include:

A history of sexually transmitted disease (STD)
Any instrument inserted into the urethra (such as a catheter or cystoscope)
Benign prostatic hyperplasia (BPH)
Injury or trauma to the pelvic area
Repeated episodes of urethritis

Strictures that are present at birth (congenital) are rare. Strictures in women are also rare.

Symptoms

Blood in the semen
Bloody or dark urine
Decreased urine output
Difficulty urinating
Discharge from the urethra
Frequent or urgent urination
Inability to urinate (urinary retention)
Incontinence
Painful urination (dysuria)
Pain in the lower abdomen
Pelvic pain
Slow urine stream (may develop suddenly or gradually)
Spraying of urine stream
Swelling of the penis

Exams and Tests

A physical examination may show the following:

Decreased urinary stream
Discharge from the urethra
Enlarged (distended) bladder
Enlarged or tender lymph nodes in the groin (inguinal) area
Enlarged or tender prostate
Hardness (induration) on the under surface of the penis
Redness or swelling of the penis

Sometimes the exam reveals no abnormalities.

Tests include the following:

Cystoscopy
Post-void residual (PVR) volume
Retrograde urethrogram
Tests for chlamydia and gonorrhea
Urinalysis
Urinary flow rate
Urine culture

Treatment

The urethra may be widened (dilated) during cystoscopy by inserting a thin instrument to stretch the urethra while you are under local anesthesia. You may be able to treat your stricture by learning to dilate the urethra at home.

If urethral dilation is not possible, you may need surgery to correct the condition. Surgical options depend on the location and length of the stricture. If the stricture is short and not near the urinary sphincter, options include cutting the stricture via cystoscopy or inserting a dilating device.

An open urethroplasty may be done for longer strictures. This surgery removes the diseased part or replaces it with other tissue. The results vary depending on the size and location, the number of treatments you have had, and the surgeon's experience.

In cases of acute urinary retention, a suprapubic catheter may be placed as an emergency treatment. This allows the bladder to drain through the abdomen.

There are currently no drug treatments for this disease. If all else fails, a urinary diversion -- appendicovesicostomy (Mitrofanoff procedure) -- may be done. This allows you to perform self-catheterization of the bladder through the wall of the abdomen.

Outlook (Prognosis)

Treatment usually results in an excellent outcome. However, repeated therapies may be needed to remove the scar tissue.

Possible Complications

Urethral stricture may totally block urine flow, causing acute urinary retention. This condition must be treated quickly.

When to Contact a Medical Professional

Call your health care provider if symptoms of urethral stricture occur.

Prevention

Practicing safer-sex behaviors may decrease the risk of getting sexually transmitted diseases and urethral stricture.

Treating urethral stricture quickly may prevent complications such as kidney or bladder infection or injury.

References

Jordan GH, Schlossberg SM. Surgery of the Penis and Urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.

Frenkl T, Potts J. Sexually Transmitted Diseases. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 11.

Review Date: 9/7/2008
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.