stricture urethra

The urethra’s main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.

What Happens under Normal Conditions?
The bladder empties through the urethra and out of the body (called voiding). The female urethra is much shorter than the male’s. In males, urine must travel a longer distance from the bladder through the penis.

In males, the urethra is around 18 cm long tube. Strictures that happen in the first 1″ to 2″ of the urethra that urine passes through are called posterior strictures.

Strictures that happen in the last 9″ to 10″ of the urethra that urine passes through are called anterior strictures.

Causes

Men are more likely to have a urethral disease or injury because of their longer urethra. For this reason, strictures are more common in men. They are rare in women and in infants.

Stricture (narrowing of the urethra) can happen at any point from the bladder to the tip of the penis. This narrowing restricts or slows the flow of urine in.

Some common causes are:

trauma to the urethra
infection such as a sexually transmitted disease
damage from surgical tools
conditions that cause swelling
In most cases, no cause can be found.

In adults, urethral strictures are most often due to:

injury from a fall onto the scrotum or perineum
prostate surgery
kidney stone removal
urinary catheterization
other surgical tools likely to have a urethral disease or injury because of their longer urethra. For this reason, strictures are more common in men. They are rare in women and in infants.

Stricture (narrowing of the urethra) can happen at any point from the bladder to the tip of the penis. This narrowing restricts or slows the flow of urine in.

Some common causes are:

trauma to the urethra
infection such as a sexually transmitted disease
damage from surgical tools
conditions that cause swelling
In most cases, no cause can be found.

Symptoms
Simply put, the urethra is like a garden hose. When there is a kink or narrowing along the hose, no matter how short or long, the flow is reduced. When a stricture is narrow enough to decrease urine flow, you will have symptoms. Problems with urinating, UTIs, and swelling or infections of the prostate may occur. Severe blockage that lasts a long time can damage the kidneys.

Some signs are:

bloody or dark urine
blood in semen
slow or decreased urine stream
urine stream spraying
pain with urinating
abdominal pain
urethral leaking
UTIs in men
swelling of the penis
loss of bladder control.

Diagnosis
There are several tests to determine if you have a urethral stricture including:

physical exam
urethral imaging (X-rays or ultrasound)
urethroscopy (to see the inside of the urethra)
retrograde urethrogram

Treatment
There are many options depending on the size of the blockage and how much scar tissue is involved.

Treatments include:

dilation – enlarging the stricture with gradual stretching
urethrotomy – cutting the stricture with a laser or knife through a scope
open surgery – surgical removal of the stricture with reconnection and reconstruction, possibly with grafts (urethroplasty)

 

Amongst all treatment modalities Urethroplasty has best results.