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Urethral stricture
Urethral stricture is an abnormal narrowing of the urethra. Urethra is the tube that carries urine out of the body from the bladder.
Causes
Urethral stricture may be caused by swelling or scar tissue from surgery. It can also occur after a disease or injury. Rarely, it may be caused by pressure from a growing tumor near the urethra.
Other factors that increase the risk for this condition include:
- Sexually transmitted infection (STI)
-
Procedures that place a tube into the urethra (such as a catheter or
cystoscope
)
Cystoscope
Cystoscopy is a surgical procedure. This is performed to see the inside of the bladder and urethra using a telescope.
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Benign prostatic hyperplasia
(BPH)
Benign prostatic hyperplasia
The prostate is a gland that produces the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through wh...
ImageRead Article Now Book Mark Article - Injury to the pelvic area
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Repeated
urethritis
Urethritis
Urethritis is inflammation (swelling and irritation) of the urethra. The urethra is the tube that carries urine from the body.
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Strictures that are present at birth (congenital) are rare. The condition is also rare in women.
Symptoms
Symptoms include:
-
Blood in the semen
Blood in the semen
Blood in the semen is called hematospermia. It may be in amounts too small to be seen except with a microscope, or it may be visible in the ejaculat...
ImageRead Article Now Book Mark Article - Discharge from the urethra
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Bloody or
dark urine
Dark urine
The usual color of urine is straw-yellow. Abnormally colored urine may be cloudy, dark, or blood-colored.
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Strong urge to urinate and
frequent urination
Frequent urination
Frequent urination means needing to urinate more often than usual. Urgent urination is a sudden, strong urge to urinate. This causes a discomfort i...
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Inability to empty bladder
(urinary retention)
Inability to empty bladder
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 ml of urine in 24 hours (a little over 2 cups)....
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Painful urination or
difficulty urinating
Difficulty urinating
Difficulty starting or maintaining a urine stream is called urinary hesitancy.
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- Increased frequency or urgency to urinate
- Pain in the lower abdomen and pelvic area
- Slow urine stream (may develop suddenly or gradually) or spraying of urine
- Swelling of the penis
Exams and Tests
A physical exam may show the following:
- Decreased urinary stream
- Discharge from the urethra
- Enlarged bladder
- Enlarged or tender lymph nodes in the groin
- Enlarged or tender prostate
- Hardness on the under surface of the penis
- Redness or swelling of the penis
Sometimes, the exam reveals no abnormalities.
Tests include the following:
-
Cystoscopy
Cystoscopy
Cystoscopy is a surgical procedure. This is performed to see the inside of the bladder and urethra using a telescope.
ImageRead Article Now Book Mark Article - Postvoid residual (PVR) volume
- Retrograde urethrogram
-
Tests for
chlamydia
and
gonorrhea
Chlamydia
Chlamydia is an infection. It is caused by the bacteria Chlamydia trachomatis. It is most often spread through sexual contact.
ImageRead Article Now Book Mark ArticleGonorrhea
Gonorrhea is a common sexually transmitted infection (STI).
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Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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-
Urine culture
Urine culture
A urine culture is a lab test to check for bacteria or other germs in a urine sample. It can be used to check for a urinary tract infection in adults...
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Treatment
The urethra may be widened (dilated) during cystoscopy. Topical numbing medicine will be applied to the area before the procedure. A thin instrument is inserted into the urethra to stretch it. You may be able to treat your stricture by learning to dilate the urethra at home.
If urethral dilation cannot correct the condition, you may need surgery. The type of surgery will depend on the location and length of the stricture. If the narrowed area is short and not near the muscles that control the exit from the bladder, the stricture may be cut or dilated.
An open urethroplasty may be done for longer strictures. This surgery involves removing the diseased area. The urethra is then rebuilt. The results vary, depending on the size and location of the stricture, the number of treatments you have had, and the surgeon's experience.
In acute cases when you cannot pass urine, a suprapubic catheter may be placed. This is an emergency treatment. This allows the bladder to drain through the abdomen.
Suprapubic catheter
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
There are currently no drug treatments for this disease. If no other treatments work, a urinary diversion called an appendicovesicostomy (Mitrofanoff procedure) may be done. This lets you drain your bladder through the wall of the abdomen using a catheter.
Outlook (Prognosis)
The outcome is often excellent with treatment. Sometimes, treatment needs to be repeated to remove scar tissue.
Urethral stricture may totally block urine flow. This can cause sudden urinary retention. This condition must be treated quickly. Long-term blockage can lead to permanent bladder or kidney damage.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of urethral stricture.
Prevention
Practicing safer sex may decrease the risk of getting STIs and urethral stricture.
Treating urethral stricture quickly may prevent kidney or bladder complications.
References
Augenbraun MH, McCormack WM. Urethritis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 109.
Bellinger MF. Urologic disorders. In: Zitelli, BJ, McIntire SC, Norwalk AJ, eds. Atlas of Pediatric Diagnosis . 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 14.
McCammon KA, Zuckerman JM, Jordan GH. Surgery of the penis and urethra. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 40.
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Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
Review Date: 10/4/2016
Reviewed By: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
