A urethral stricture is a condition in which a scarred or inflamed urethra becomes too narrow to efficiently remove urine from the body. Strictures can be caused by a number of factors, including infections, direct trauma, and surgical procedures. The condition most often affects men of reproductive age, though strictures are occasionally seen in women and children as well. Most cases can be relieved by urologists through a procedure to manually expand the urethra with a medical balloon. Invasive surgery may be needed in the instance of a severe stricture.
Trauma to the groin area and surgical procedures for other conditions are the most common causes of urethral stricture. Sexually transmitted infections, tumors, and congenital deformities can also lead to urethral narrowing. Strictures typically appear when scar tissue builds in a small section of the urethra. Contraction usually occurs near the end of the penis or the vaginal opening, though it is possible for a stricture to develop closer to the bladder. Rarely, most or all of the urethral tube can be compressed.
The symptoms of urethral stricture can vary based on the severity and exact location of the narrowing. Most people experience decreased urine output and frequent urges to urinate. An individual might have sharp pains when urinating or a dull, narrow ache in the pelvic region and lower abdomen. The penis may swell, and blood may be present in urine and semen. An individual who experiences any possible symptoms of a urethral stricture should seek immediate medical care to avoid potentially serious complications, such as kidney or bladder infections.
A urologist can usually diagnose a urethral stricture by inserting a tool called a cytoscope into the urethral opening. A cytoscope is a small tube equipped with a camera that transmits images to a computer screen, allowing the doctor to pinpoint the site of scarring and narrowing. The urologist may decide to collect urine, semen, or tissue samples for laboratory analysis to check for viral or bacterial infections. After making an accurate diagnosis, the doctor can explain different treatment options.
The most common procedure to relieve a stricture is called urethral dilation. The urologist inserts a balloon into the urethra and slowly inflates it, thereby spreading the walls of the tube. When the balloon is deflated and removed, the urethra generally maintains its wider shape. A recurring stricture may require frequent dilations, either performed in the urologist's office or at home with a specialized kit provided by a doctor.
A urologist may decide that surgery is the best option for a long or severe stricture. A surgical specialist can usually resolve a stricture by excising scar tissue with a scalpel, taking care not to damage surrounding tissue. A permanent stent may need to be placed in the urethra if excision surgery is not successful. Patients may need to use catheters for several days following surgery and attend regular checkups with their urologists for recovery monitoring. With treatment, most people experience full recoveries within about one year.
