A urethral stricture is a narrowing of a section of the urethra. The urethra is a tube, or ‘water pipe’ which carries urine from the bladder. A urethral stricture is a narrowing of the urethra, resulting in symptoms such as difficulties passing urine.
Strictures occur more commonly in men than in women because the male urethra is longer. In men, the urethra passes through the penis and in women, the urethra ends just above the vagina.
Birmingham Prostate Clinic consultant urologist Mr Paul Anderson is one of the UK’s leading experts in the treatment of urethral strictures, carrying out in excess of 100 urethroplasties each year.
Causes of a urethral stricture
- Trauma, injury or damage to the urethra are the most common causes of a urethral stricture. Any damage to the urethra can lead to a build up of scar tissue causing narrowing and difficulty passing urine. Damage can be the result of a procedure to examine the bladder via the urethra, a TURP procedure, a fracture or rupture to the pelvis, or a simple catheterisation.
- Infection may cause inflammation in the tissues in and around the urethra. Infections usually clear with treatment but in some cases, scar tissue remains at the site of the inflammation, causing a stricture. Infection can develop from long-term use of a catheter, or as a result of a sexually transmitted disease.
- Cancer is a much rarer cause, but cancer in the urethra can lead to the development of a stricture.
- In some cases, strictures will develop without a known cause.
Symptoms of a urethral stricture
- Normally, the first symptom is a reduced urine flow and straining to pass urine.
- Spraying of urine or a ‘double stream’ can occur.
- Dribbling of urine for a while after the main flow of urine has finished.
- Frequency sometimes occurs (needing to pass urine more often than normal).
- Urine infections.
- There may be a reduced force of ejaculation.
- Mild pain on passing urine sometimes occurs.
The range of symptoms varies from one individual to another, but symptoms tend to increase in severity over time.
Complications of urethral stricture
When you go to the toilet, you may not be able to fully empty your bladder due to the stricture. Consequently, some urine may ‘pool’ in the bladder, which leads to an increased risk of bladder, prostate and kidney infections. In some cases, an abscess (a ball of infection) can form above the stricture, causing further damage to the urethra.
How is a urethral stricture diagnosed?
There are several tests used by urologists to diagnose a stricture:
- A cystoscopy involves examining the urethra using a special thin and flexible telescope.
- A flow test is an assessment of how much urine is passed per second. Flow rate is much reduced if a stricture is present.
- An x-ray may be taken while you pass urine to show the site and severity of the urethral stricture.