Slow urinary stream, straining to urinate, spraying of urine, inability to urinate, painful urination or blood in the urine may be signs of urethral stricture disease or narrowing of the urethra. If left untreated, this disease can cause kidney and bladder damage and infections from obstructed urine flow. Fortunately, urethral stricture disease can be treated.

What Is Urethral Stricture Disease?

The urethra is the channel that urine passing through after leaving the bladder. Urethral stricture disease happens when the urethra narrows, causing difficulty or discomfort when a person urinates. This is typically from scar tissue in the urethra called a stricture. This can occur in both men and women. This condition can occur in any area from the opening of the bladder to meatus or tip of the urethra. Symptoms may include:

• Dark or bloody urine
• Pain during urination
• Incomplete emptying
• Decreased or slow urine stream
• Urinary tract infections (UTIs)
• Loss of bladder control
• Abdominal pain or fullness
• Inability place a catheter in the bladder

Consult with a doctor if you experience any of these urethral stricture symptoms so several tests may be recommended to determine if you have urethral stricture, such as:

• Physical exam
• Urethral x-ray or Retrograde urethrogram to see the number of strictures in the urethra, their position, severity and length
• Cystoscopy to view the inside of the urethra and bladder

What Causes Urethral Stricture?

Some causes of urethral stricture may include:

• Sexually transmitted disease or other infection
• Trauma or injury to the urethra
• Complications from a previous surgery

How To Treat Urethral Stricture?

Currently, there are no medications to treat urethral stricture. A person affected by this condition will continue to experience symptoms and may be at risk of infection, bladder or kidney damage. Urinary retention or the inability to pass urine may also occur.

There are a range of urethral stricture treatment options are available depending on multiple factors including length of stricture and prior surgical history:

• Dilation – involves stretching open the narrowed areas in the urethra using a series of dilators from smallest to largest. This may also be done with a balloon. There are now drug coated balloons that help decrease the growth of scar tissue.
• Urethrotomy – the use of a special scope with a laser or knife at the end which is used to cut the stricture to widen it. This may also be used in combination with the drug coated balloons mentioned above.
• Urethroplasty
  • Anastomotic urethroplasty – usually reserved for short urethral strictures, this procedure involves removing the scar tissue that’s causing the stricture and reconnecting the two ends of the urethra back to one another.
  • Substitution urethroplasty – this procedure may be recommended if the stricture is long. In this procedure, tissue will be used to replace the area of the urethra with stricture.
  • Perineal urethrostomy – creation of a new urethral opening in the skin between the scrotum and anus.

Your doctor will discuss your treatment options based on your stricture size, its severity and other factors, as well as your preferences and results from your medical examination.

Here are some questions to ask your doctor before treatment:

• What are the pros and cons of each treatment?
• What are the side effects of urethral stricture surgery?
• What preparation do I need before surgery?
• What possible problems could happen during or after surgery?
• How can I prevent the urethral stricture from coming back?
• How long will I need to follow up care?

Since it’s possible for strictures to come back after surgery, regular consultation with a urologist may help check how you’re healing from your procedure. In some cases, the strictures may return but may not require additional treatment. However, recurring serious strictures may have to be treated with surgery.