Merck Manual

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Urethral Stricture

By

Patrick J. Shenot

, MD, Thomas Jefferson University Hospital

Reviewed/Revised Aug 2023
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Topic Resources

A urethral stricture is scarring that narrows the urethra.

A urethral stricture may be

A urethral stricture most commonly results from a previous injury. Prior infection, such as a sexually transmitted infection, is now an infrequent cause. Often no cause can be found.

The Urethra
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Symptoms of Urethral Stricture

A less forceful urinary stream or a double stream usually occurs when the urethra is slightly narrowed. Severe narrowing 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 Overview of Urinary Tract Infections (UTIs) In healthy people, urine in the bladder is sterile—no bacteria or other infectious organisms are present. The tube that carries urine from the bladder out of the body (urethra) contains no bacteria... read more .

Diagnosis of Urethral Stricture

  • Retrograde urethrography

  • Cystoscopy

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 contrast agent into the urethra (retrograde urethrography Retrograde urography There are a variety of tests that can be used in the evaluation of a suspected kidney or urinary tract disorder. (See also Overview of the Urinary Tract.) X-rays are usually not helpful in evaluating... read more ) or by looking directly into the urethra through a flexible viewing tube (cystoscopy Cystoscopy A doctor can diagnose some disorders of the bladder and urethra (for example, bladder tumors, stones in the bladder, benign prostatic enlargement) by looking through a flexible viewing tube... read more ) after administering a lubricant containing a local anesthetic.

Treatment of Urethral Stricture

  • Widening the urethra

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 and using a small knife or a fiber laser to make the cuts.

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 (urethroplasty).

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