Causes and Risks:

Urethral stricture may be caused by inflammation or scar tissue resulting from urethral or prostate surgery, disease or injury. It may also be caused by external pressure from an enlarging tumor near the urethra although this condition is rare. Increased risk is associated with men who have a history of sexually transmitted disease, repeated episodes of urethritis, or benign prostatic hyperplasia. There is also increased risk of urethral stricture after an injury or trauma to pelvic region. Any instrumentation of the urethra (catheterization or cystoscopy) increases the chance of developing urethral strictures.

Congenital (present at birth) pediatric strictures are rare, as are true strictures in women.

Prevention:

Practicing safer sex behaviors may decrease the risk of contracting sexually transmitted diseases and subsequent urethral stricture.

Early treatment of urethral stricture may prevent complications such as kidney or bladder infection or injury.

Symptoms:

• dysuria (painful urination)
• difficulty urinating
• slow urine stream (this may develop either suddenly or gradually)
• spraying of urinary stream
• urine output, decreased
• urinary frequency/urgency, increased
• incontinence
• blood in the semen
• pelvic pain
• lower abdominal pain
• urine, bloody or dark
• discharge from the urethra
• penis swelling
• urinary retention

Signs and Tests:

A physical examination may reveal:

• a decreased urinary stream
• no abnormalities
• enlarged or tender lymph nodes in the inguinal areas
• redness or swelling of the penis
• urethral discharge
• enlarged/tender prostate
• distended bladder

Tests:

• Urinary flow rate may be measured
• Post-void residual (PVR) measurement
• A urinalysis
• Urine culture if evidence of infection
• Tests may be done for Chlamydia and gonorrhea
• A cystoscopy to confirm diagnosis
• A retrograde urethrogram may also confirm diagnosis

Treatment:

Placement of a urethral catheter, if possible, or a suprapubic tube (a tube through the abdomen into the bladder) may temporarily alleviate acute problems like urinary retention.

For more definitive treatment dilation of the urethra may be attempted by inserting a sound (a thin instrument used to stretch the urethra) under local anesthesia. If urethral dilation is not possible, surgery may be necessary to correct the condition.

There is no medical treatment currently available for this disease.

Prognosis:

Treatment usually results in an excellent outcome.

There is a high recurrence rate of redeveloping strictures.

Complications:

Urethral stricture may totally block urine flow, causing acute urinary retention, a condition that must be alleviated quickly.

Call your health care provider if symptoms of urethral stricture occur.