Urethral Strictures

What is a urethral stricture?

A urethral stricture occurs when scarring narrows the water pipe that carries urine out of your body. A stricture restricts the flow of urine from the bladder and can cause a variety of medical problems in the urinary tract, including reduced urine stream, urine infections and inability to urinate.

What are the symptoms of urethral stricture?

Symptoms include slowing of the urine stream, spraying of the urine stream, dribbling after urination, pain during urination, blood in the urine, urethral discharge or urine infections.

What are the causes of a urethral stricture?

Causes of urethral strictures include:

  • Trauma to the urethra from surgery such as TURP or long-term catheter use
  • Trauma to urethra from direct injury to the urethra or a pelvic fracture
  • Sexually transmitted infections
  • Radiotherapy or brachytherapy

Urethral stricture is rare in women because the female urethra is much shorter.

How is it diagnosed?

Your doctor will recommend a number of tests to assess for urethral stricture. These may include:

  • Urine analysis to assess for infection and blood in the urine
  • Urine flow test – assess strength of urination, and bladder emptying
  • Urethrogram – dye is injected into the urethra and X-rays are taken to assess the location and length of the scarring
  • Cystoscopy – a tube like camera is passed into the urethra to assess the inside

How is it treated?

Treatment initially involves dilatation/stretching of the scar tissue or cutting the scar tissue with a knife or laser with cystoscopy. This will increase the lumen of the urethra to the original normal size. Sometimes this will fix the problem permanently, but frequently scarring and urethral stricture will recur because of recurrent scarring of the urethra tube.

Subsequent treatment options include:

Self Catheterisation – a catheter is passed in and out of the urethra by the patient on a regular basis to keep the urethral scarring from progressing

Urethroplasty – this involves surgical reconstruction the urethra. The scarred and diseased section of your urethra is removed and normal urethra is joined together. Sometimes, tissue from the inside of the mouth is required to be grafted on to the narrowed urethra to enlarge it. The recurrence of strictures after urethroplasty is low.

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