What is a urethral stricture?

A urethral stricture is a condition in which a scarred or inflamed urethra becomes too narrow to efficiently remove urine from the body. Stenoses can be caused by a number of factors, including infection, direct trauma, and surgical procedures. The condition most commonly affects men of reproductive age, although strictures are also occasionally seen in women and children. Urologists can relieve most cases with a procedure to manually expand the urethra with a medical balloon. Invasive surgery may be necessary in the case of severe urethral stricture.

Trauma to the groin area and surgical procedures for other conditions are the most common causes of urethral stricture. Sexually transmitted infections, tumors, and congenital deformities can also cause urethral narrowing. Strictures usually appear when scar tissue builds up in a small section of the urethra. The contraction usually occurs near the end of the penis or the vaginal opening, although a stricture may develop closer to the bladder. Rarely, most or all of the urethral tube may be compressed.

Symptoms of urethral stricture can vary depending on the severity and exact location of the narrowing. Most people experience decreased urine output and frequent urges to urinate. A person may have sharp pains when urinating or a dull, narrowing pain in the pelvic region and lower abdomen. The penis may swell and blood may be present in the urine and semen. A person experiencing any possible symptoms of a urethral stricture should seek immediate medical attention to avoid potentially serious complications, such as kidney or bladder infections.

A urologist can usually diagnose a urethral stricture by inserting a tool called a cystoscope into the urethral opening. A cystoscope is a small tube equipped with a camera that transmits images to a computer screen, allowing the doctor to determine the site of scarring and narrowing. The urologist may decide to collect urine, semen, or tissue samples for laboratory analysis to check for viral or bacterial infections. After making an accurate diagnosis, the doctor can explain different treatment options.

The most common procedure to relieve a stricture is called urethral dilation. The urologist inserts a balloon into the urethra and slowly inflates it, thus stretching the walls of the tube. When the balloon is deflated and removed, the urethra generally maintains its wider shape. A recurrent stricture may require frequent dilations, either in the urologist's office or at home with a specialized kit provided by a doctor.

A urologist may decide that surgery is the best option for a long or severe stricture. A surgical specialist can usually resolve a stricture by removing the scar tissue with a scalpel, taking care not to damage the surrounding tissue. A permanent stent may need to be placed in the urethra if excision surgery is unsuccessful. Patients may need to wear catheters for several days after surgery and attend regular check-ups with their urologists to monitor recovery. With treatment, most people make full recoveries in about a year.

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