Urethral Stricture: Symptoms, Causes, Treatments

Published 2019/12/06

This article will go over the causes, symptoms, and treatments of urethral stricture.

Urethral stricture is the narrowing of the urethra. It can be caused by the build-up of scar tissues post urethral trauma. The scar tissue obstructs the pathway through which urine exits the body, which can lead to urinary retention, UTIs, pain, and inflammation. Chronic inflammation as the result of UTIs also causes urethral stricture.

Urethral Stricture Causes

Study finds that 45% of urethral stricture results from injuries relating to medical examination or treatment, 30% are due to unknown reasons, and 20% are due to bacterial urethritis (urethral inflammation caused by bacteria).

When the urethra is injured during medical procedures or by accident, scar tissue can form and obstruct the urethra.

Examples of medical procedures that can lead to urethral stricture are:

Intermittent catheterization
Long-term use of indwelling catheters
Insertion of an endoscope into the urethra
Radiation therapy for cancer treatment

Other times, scar tissue forms as a result of accidental injuries to the urethra. In men, pelvic fractures injure the first one to two inches of the urethra, leading to posterior urethral stricture.

Anterior urethral stricture happens in the last nine to ten inches of the urethra due to traumas caused by straddling, catheterization and injury to the penis.

STI and UTIs cause inflammation of the urethra, leading to urethral stricture. Some common bacterial culprits are:

E. Coli
Gonorrhea
Chlamydia

Urethral stricture can occur at any point in the urethra. The causes of urethral stricture are similar in men and women, but because men have longer urethras than women, it occurs more commonly in men.

Urethral Stricture Symptoms

Urethral stricture causes urinary retention, the inability for urine to exit the body. Symptoms include:

Urgent need to urinate with little success
Frequent urination, more than eight times a day
Inability to start urination or having weak, broken streams
Pain, discomfort, fullness in the lower abdomen
Having to urge to urinate right after urination

Urethral stricture leads to urinary retention, which leads to an increased risk of UTIs. Symptoms of UTIs include:

Painful, burning urination
Cloudy, bloody, dark, foul-smelling urine
Fatigue and shakiness
Pain or pressure in the lower abdomen
Fever and chills, pain in the back, groin and flank, nausea and vomiting (kidney infection)

Urethral stricture treatment
and surgery

There is no available drug that can treat urethral stricture, but there are other options available.

Urethral dilation—inserting a special device into the urethra and dilate areas of stricture through gradual stretching.
Urethrotomy—using lasers or scalpels to remove the stricture with the guidance of a cystoscope. The recurrence of urethral stricture is possible.
Urethroplasty (open surgery)—surgically removing or enlarging the narrow section of the urethra. Sometimes it requires reconstructions of surrounding tissues using tissues grafted from other parts of the body. The recurrence of urethral stricture is very unlikely.
Catheterization—passing a thin hollow tube through the urethra into the bladder to drain urine. This does not get rid of urethral stricture but allows urine to drain normally to avoid urinary retention and UTIs.

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