The urethra is the tube that carries urine from the bladder out of the body. When it is a normal width, urine flows through it easily and freely, but when it narrows, the flow becomes restricted. This narrowing is known as a urethral stricture. It mainly affects men, though women can be affected too.
Causes
- A urethral stricture is caused by inflammation of the tissues or the development of scar tissue.
- A common cause is previous catheterisation, carried out during an earlier hospital admission.
- Straddle injuries can lead to a stricture, for example being struck in the groin by a bicycle crossbar or a manhole cover. These injuries can present as emergencies.
- Pelvic fractures.
- Pelvic radiation of any kind.
- Surgery performed on the prostate.
- A tumour situated close to the urethra.
- Untreated or recurring urinary tract infections.
- Sexually transmitted infections (STIs).
- In some cases no cause can be identified (idiopathic).
Symptoms
Some of the symptoms of a urethral stricture are:
- A weak urine flow.
- A reduction in the volume of urine passed.
- A frequent urge to urinate.
- A burning sensation or pain while passing urine.
- Difficulty controlling or holding urine.
- Swelling and pain in the penis.
- Blood in the urine or semen.
- Darkening of the urine.
- An inability to pass urine at all.
Diagnosis
If you notice any of the symptoms above, you should consult a urologist promptly. The doctor will discuss your symptoms and your past medical history, and may examine the genital area. Tests are usually carried out to measure the rate of urine flow, along with urine tests. A cystoscopy may be performed to view the inside of the bladder and urethra, and special X-rays may also be arranged. If you have noticed blood in your urine, mention it, as this is an important symptom to investigate.
Treatment
Treatment depends on the severity of the condition. The options for a urethral stricture include the following.
Non-surgical: A dilator is used to widen the urethra. The doctor passes a fine wire through the urethra into the bladder to stretch it, gradually increasing the width of the passage. Another approach is placing a permanent urinary catheter, which is used in severe cases.
Surgery
- Endoscopic: an endoscope is used to open up the narrowed segment.
- Open: an open urethroplasty is performed, generally for severe strictures. This involves removing the affected tissue and reconstructing the urethra.
Your urologist will explain each procedure and the sub-types available in more detail.
Prevention
It is not always possible to prevent a urethral stricture, as STIs are among the causes. Using protection during sexual activity can reduce this risk to some extent. Other medical conditions and injuries linked to strictures are harder to avoid. If you develop any of the symptoms described above, consult a doctor, as treating the condition early can help prevent complications.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs. If you have symptoms or a question about your health, book a consultation with Dr. Anish Gupta.