Urethral Stricture Disease

A urethral stricture occurs when scar tissue narrows the tube that carries urine out of your body. This restricts the flow of urine from your bladder and can cause uncomfortable symptoms and medical problems in the urinary tract, including inflammation or infection. Get a complete exam from the expert urologists at OU Health and find the best path forward for your condition.

Symptoms

Urethral stricture disease can cause symptoms that may resemble enlarged prostate (BPH) as well as others including:

• Abdominal pain

• Blood in semen

• Bloody or dark urine

• Decreased urine stream

• Difficulty, straining or pain when urinating

• Incomplete bladder emptying

• Increased urge to urinate or more-frequent urination

• Loss of bladder control

• Spraying of the urine stream

• Swelling of the penis

• Urinary tract infection

Causes, Symptoms & Diagnosis

A short procedure called a cystoscopy allows your doctor to view the inside of the urethra to diagnose the condition and help determine the cause, which may include:

• Previous urologic surgery – Procedures such as transurethral resections for enlarged prostate or removal of bladder tumors requiring a large scope or catheter, or radiation for prostate cancer, may inadvertently damage tissue and create scarring in urethra
• Trauma – Direct injury such as saddle trauma (falling on bicycle crossbar or similar groin-area injuries); symptoms may develop immediately or may take months or years; severe trauma such as car accidents may fracture the pelvis and disconnect urethra from bladder
• Infection or inflammation – Includes chronic conditions such as lichen sclerosus (LS), balanitis xerotica obliterans (BXO), sexually transmitted infections (STIs); may also appear as penile skin discoloration and scarring
• History of hypospadias – Congenital issue with formation of urethra in boys; early surgical repair procedures may lead to later development of urethral stricture

A quick additional X-ray with injectable dye helps your doctor view the full length of the urethra and determine the exact length and location of the stricture.

Treatments for Urethral Stricture Disease

Based on the results of your exam and diagnostic imaging, you and your doctor will discuss treatment options, which may include:

• Urethral dilation – Stretches the sides of the urethra with dilating instruments and a cystoscope (thin tube with camera)

• Direct vision internal urethrotomy (DVIU) – Endoscopic procedure that inserts a temporary catheter to stretch and repair urethral stricture

• Urethroplasty – Surgical reconstruction or replacement of a narrowed urethra to restore function