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Urethral stricture is a condition characterized by the narrowing of the urethra, the tube that carries urine from the bladder to the outside of the body. This narrowing is caused by scar tissue or inflammation, which restricts the flow of urine and can lead to various urinary problems. Urethral strictures are more common in men due to the longer length of the male urethra, but they can also occur in women and children, albeit less frequently.
The most common causes of urethral strictures include trauma to the urethra, such as from pelvic injuries or surgical procedures involving the urethra or bladder. Other causes include repeated urinary tract infections (UTIs), sexually transmitted infections (STIs), insertion of medical instruments (e.g., catheters), or conditions like lichen sclerosus, which affects the genital skin. In some cases, the exact cause remains unknown, termed idiopathic strictures.
Symptoms of a urethral stricture can range from mild to severe and include difficulty urinating, a weak or slow urine stream, frequent urination, incomplete bladder emptying, and urinary tract infections. In severe cases, complete blockage of the urethra may occur, leading to acute urinary retention, a medical emergency. Pain during urination or ejaculation and blood in the urine or semen may also be associated with the condition.
Treatment for urethral strictures depends on the severity and length of the stricture. Mild cases may be managed with urethral dilation, where the urethra is gently stretched using specialized instruments. More complex or recurrent strictures may require surgical intervention, such as urethrotomy (cutting the stricture with a scope) or urethroplasty, a reconstructive surgery to remove or repair the affected segment of the urethra. Urethroplasty is considered the gold standard for long-term resolution of strictures and has a high success rate.
Proper diagnosis and treatment are essential to prevent complications such as recurrent infections, bladder damage, or kidney issues. Diagnosis typically involves imaging studies, such as a retrograde urethrogram or ultrasound, and sometimes cystoscopy to visualize the stricture. Patients experiencing urinary symptoms should consult a urologist for evaluation and individualized care. With appropriate treatment and follow-up, most individuals can achieve relief from symptoms and regain normal urinary function.
