Urethral Stricture Disease

Internal scar tissue that narrows the urethra, the tube from the bladder extending to the tip of the penis, can create difficulty or pain with voiding, urinary tract infections, blood in urine or issues with urgency or frequency. Symptoms may resemble enlarged prostate (BPH) in middle-aged men, so be sure to get a complete exam from your urologist, especially if simple prostate medications don’t help.

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.