What is Urethral Stricture Disease?
A urethral stricture is a narrowing of the urethra due to scar tissue, which may block the flow of urine and cause inflammation and infection.
Urethral Stricture Symptoms
Symptoms of urethral stricture include:
- Decreased urine flow
- Inability, or perceived inability, to fully empty bladder (urinary retention)
- Increased urinary frequency
- Increased urinary urgency
- Painful urination
- Urinary tract infections (UTIs)
- Bloody urine
Urethral Stricture Causes
The scar tissue responsible for urethral stricture may be caused by the following:
- Medical procedures, such as endoscopes, in which instruments are inserted into the urethra
- Long term catheter use
- Traumatic injury to the pelvic area
- Inflammation of the prostate gland
- Urinary Tract Infections
- Urethral or Prostate Cancer
- Sexually transmitted diseases
- Radiation therapy and chemotherapy
- Surgical complications
Urethral strictures are much more common in men than in women due to the increased length of the urethra.
Urethral Stricture Diagnosis
To diagnose urethral stricture, physicians will begin by performing a physical exam, to rule out other problems. Next, the physician may order a urine culture to rule out infection. If there is no infection, the physician may order imaging tests, such as an x-ray or ultrasound, to produce images of the urethra. If a stricture is present, the imaging tests will determine its severity and complexity.
If these tests are inconclusive or indicative of a urethral stricture, the physician may perform a cystoscopy and examine the bladder by inserting a lighted scope through the urethra via a catheter. Urodynamic tests may also be conducted to assess how well the bladder and the urethra are storing or releasing urine. These tests measure urinary flow in terms of speed and volume (uroflowmetry) and pressure (pressure flow study).
Urethral Stricture Treatment
Urethral strictures are most commonly treated through:
- Catheterization, the insertion of a small tube into the bladder in order to drain urine, which may immediately relieve symptoms of urethral stricture.
- Urethral dilation, the insertion of rubber or metal into the urethra to stretch scar tissue while the patient is under anesthesia. Progressively larger rods are used to increase dilation and expand the narrow urethra.
- Endoscopic urethrotomy, the insertion of instruments capable of destroying the stricture through a thin optical device called a cystoscope.
- Urethroplasty, the repair of the urethra after the removal of scar tissue. For severe strictures requiring extensive repair, tissue from the mouth may be used to rebuild the urethra.