What is a Urethral Stricture?

Urethral strictures are a medical condition characterized by the narrowing of the urethra, the tube that carries urine from the bladder out of the body. This narrowing can restrict or block the flow of urine, leading to various symptoms and complications.

Causes of Urethral Strictures:

1. Scar Tissue Formation: The most common cause, often due to:
– Injury or trauma to the urethra (e.g., from a fall, accident, or pelvic fracture).
– Medical procedures involving the urethra, such as catheterization or cystoscopy.
– Infections, such as sexually transmitted infections (STIs) like gonorrhea or chlamydia.

2. Inflammation: Chronic inflammation from conditions like lichen sclerosus or recurrent urinary tract infections (UTIs).

3. Congenital Issues: Rarely, strictures may be present from birth due to abnormal development of the urethra.

4. Radiation Therapy: Previous radiation treatment for pelvic cancers can cause scarring and strictures.

Symptoms of Urethral Strictures:

• Difficulty Urinating: Weak or reduced urine stream.
• Pain or Burning: During urination.
• Frequent Urination: Feeling the need to urinate often.
• Incomplete Emptying: Sensation that the bladder isn’t fully emptied.
• Urinary Retention: Inability to urinate, which is a medical emergency.
• Urinary Tract Infections (UTIs): Recurrent infections due to incomplete bladder emptying.
• Blood in Urine: Hematuria may occur in some cases.

Diagnosis:

• Medical History and Physical Exam: A healthcare provider will assess symptoms and risk factors.
• Imaging Tests: Such as a retrograde urethrogram or ultrasound to visualize the stricture.
• Urethroscopy: A scope is used to directly examine the urethra.
• Urine Flow Test: Measures the speed and volume of urine flow.

Treatment Options:

• Dilation: Gradually stretching the narrowed area using special instruments.
• Urethrotomy: A surgical procedure to cut the stricture open using a laser or knife.
• Urethroplasty: Surgical reconstruction of the urethra, often using tissue grafts, for more severe or recurrent strictures.
• Stent Placement: A temporary or permanent stent may be placed to keep the urethra open.
• Catheterization: In some cases, a catheter may be used to relieve urinary retention.

Prevention:

• Avoiding trauma to the urethra.
• Treating infections promptly, especially STIs.