Urethral stricture: What causes it?

A urethral stricture is a narrowing in any part of the urethra — the tube that drains urine from the bladder. This impairs normal urine flow. Urethral strictures occur primarily in men because they have a longer urethra than women do. Causes include:

• Urethral injury, disease, catheterization or surgery that results in inflammation or scar tissue
• Urethral infections, such as gonorrhea
• Rarely, a tumor in the urethra

Strictures may also be present at birth (congenital), but this is uncommon. Signs and symptoms of a urethral stricture include:

• Decreased urine flow
• Incomplete emptying of bladder
• Painful urination
• Urinary tract infection
• Blood in the urine

A doctor can confirm a diagnosis by:

• X-ray with dye injection into the urethra
• Cystoscopy, a procedure in which your doctor inserts a narrow tube (cystoscope) with a camera attached into the urethra

Treatment of urethral strictures may include:

• Inserting a tube in the abdomen (suprapubic catheter) to drain the bladder for temporary, short-term relief
• Dilating the stricture by inserting a narrow instrument into the urethra
• Internal incision of the stricture via a cystoscope or endoscope
• Placing a permanent catheter through the urethra to drain the bladder
• Surgery to correct the condition (open urethroplasty)

The use of urethral stents was a promising development in the treatment of strictures. But such stents had poor long-term results. As a result, stents are now only rarely used in the treatment of urethral strictures.

Without appropriate treatment, the stricture will almost always recur.