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Urethral Stricture

by Patrick J. Shenot, MD

A urethral stricture is scarring that narrows the urethra.

A urethral stricture most commonly results from a previous injury. Often no cause can be found. Strictures can be present at birth. Prior infection, such as a sexually transmitted disease, is now an infrequent cause. A less forceful urinary stream or a double stream usually occurs when the urethra is slightly narrowed (mild stricture). Severe strictures may completely block the stream of urine. Pressure builds up behind the stricture and may cause passages from the urethra into the surrounding tissues (diverticula). By decreasing the frequency or completeness of urination, strictures often lead to urinary tract infections.

Urologists (doctors who specialize in the diagnosis and treatment of disorders of the urinary tract and male reproductive system) diagnose strictures by obtaining an x-ray after putting radiopaque dye into the urethra (retrograde urethrogram) or by looking directly into the urethra through a flexible viewing tube (cystoscope) after administering a lubricant containing a local anesthetic.

To treat a stricture, urologists widen (dilate) the urethra by anesthetizing it and then inserting an instrument that forces the narrowing farther open. Sometimes urologists can cut the stricture open (urethrotomy) by passing an instrument into the urethra. Rarely scar tissue forms after strictures are treated, causing urethral strictures to recur. If strictures recur, the scar tissue may have to be removed surgically and the urethra may need to be rebuilt.