Urethral stricture disease is one cause of lower urinary tract symptoms. Urethral strictures occur when scar tissue forms in the urethra (the tube which carries urine out of the bladder). Typically this occurs in men due to the longer urethra, but in rare cases can present in women. The scar tissue results from trauma, surgery on the urinary system, urinary tract infection, or sexually transmitted diseases.
- Slowing/Dribbling of the Urinary Stream
- Frequent Urinary Tract Infections
- Incomplete emptying of the bladder
- Straining to urinate
- Painful urination
- Blood in the urine
X-ray testing and cystoscopy (a camera placed into the urethra for direct visualization) are the typical examinations used to determine the complexity of strictures.
There are two main treatment options for strictures:
Urethral Dilation – This is an outpatient procedure where the scar tissue is either stretched or cut under anesthesia.
Urethroplasty – This is an operation for either recurrent strictures or more complex areas of scar tissue. The procedure involves a small incision where the scar tissue is removed and the urethra is repaired.
Longer more complex strictures may require using tissue from the lining of the cheek (buccal mucosa) to repair the urethra. Though this procedure uses a small incision and a overnight stay in the hospital, the success rates range from 85-92% successful in eliminating the problem long term.
Are multiple urethral dilations a way to manage my stricture?
Urethral dilations can be a easy and successful way to treat a urethral stricture but the long term success is low (30%). If your stricture returns, you should consider being evaluated for Urethroplasty for better long term result (85-92% successful)
Is there another treatment option besides surgery?
Unfortunately, once scar tissue forms in the urethra there are no medications or injections that are effective at treating urethral stricture.