Urethral Stricture is an abnormal narrowing of the urethra, the tube that carries urine out of the body from the bladder. This condition may be caused by inflammation or scar tissue from surgery, disease or injury. It may also be caused by pressure from a growing tumor near the urethra, although this is rare.
Risks include:
- Sexually transmitted infection (STI)
- Procedures that place a tube into the urethra (such as a catheter or cystoscope)
- Injury to the pelvic area
- Repeated urethritis
Strictures that are present at birth (congenital) are rare. Strictures in women are also rare.
Symptoms
- Bloody or dark urine
- Decreased urine output
- Difficulty urinating
- Discharge from the urethra
- Frequent or urgent urination
- Inability to urinate (urinary retention)
- Incontinence
- Painful urination (dysuria)
- Pain in the lower abdomen
- Pelvic pain
- Slow urine stream (may develop suddenly or gradually)
- Spraying of urine stream
Diagnosis
Your Ohio State urologist will discuss your health history and complete a physical exam to determine if any of these conditions are present:
- Decreased urinary stream
- Discharge from the urethra
- Enlarged (distended) bladder
- Enlarged or tender lymph nodes in the groin (inguinal) area
Tests may be conducted, such as:
- Cystoscopy involves insertion of a small tube with a miniature camera on the end to view the urethra and bladder.
- Measurement of post-void residual (PVR) volume
- Tests for sexually transmitted diseases, such as chlamydia and gonorrhea
- Urinalysis, a study of your urine to determine whether you have a disease without showing symptoms
- Urinary flow rate
- Urine culture to determine if bacteria are present in your urine
Treatment
Medication
There are currently no medications to treat this condition.
Cystoscopy
The urethra may be widened (dilated) during cystoscopy by inserting a thin instrument to stretch the urethra while you are under local anesthesia. You may be able to treat your stricture by learning to dilate the urethra at home.
Surgery
An open urethroplasty may be done for longer strictures. This surgery involves removal of the diseased part followed by reconstruction.
In cases of acute urinary retention, a catheter may be placed as an emergency treatment. This allows the bladder to drain through the abdomen.
When no other options are available, a urinary diversion may be done. This allows you to perform self-catheterization of the bladder through the wall of the abdomen.
