urethral stricture

What is a urethral stricture and how is it treated?

A urethral stricture is a narrowing of the pipe that leads out of the bladder to the genitals (along the penis in a man). the narrowing is usually caused by injury or inflammation (often caused by infection). It can occurr in both men and women. It causes a poor urinary flow and problems emptying the bladder. In severe cases it can cause a complete blockage and inability to pass urine at all (urinary retention).

It can be diagnosed by a number of tests. A flow test, in which urine is passed into a machine that measures the speed of urination, can be useful to first show how slow the stream of urine is. It may then be necessary to either look into the urethra and bladder (cystoscopy) or in men dye can be introduced into the urethra and followed along the penis using x-rays (urethrogram) to look for blockages.

A stricture can be treated by stretching (urethral dilatation) or internal cutting (optical urethrotomy, which is usually not used in women) the narrowed area. This type of operation usually needs a general anaesthetic. There are risks the the operation might cause bleeding, infection or discomfort, and in the long term the stricture can recurr so follow-up is usually required. In recurrent cases patients might be advised to learn to perodically pass a small catheter tube into the urethra to keep the stricture stretched open.  An alternative approach would be to consider a much longer operation to remove  and resurface the stricture (urethroplasty, which is not usually used in women). This type of operation has a much lower risk of stricture recurrence, but is a more major procedure.