The urethra is the narrow passage through which urine exits the body. It runs from your bladder to the outside, ending at the tip of the penis in men and in front of the vagina in women.
In medical terms, a stricture refers to a narrowing or blockage in a tube-like structure in the body.
When we talk about a urethral stricture, we're referring to a narrowing in the urethra. A urethral stricture constricts and limits urine flowing out of the bladder, making it harder for it to pass through.
Not only is urinating difficult, it is also painful.
What Causes a Urethral Stricture?
A stricture can develop due to long-lasting inflammation or scar tissue forming in the urethra. Common causes include:
- Damage or trauma to your urinary tract
- Infections, especially sexually transmitted infections (STIs) like chlamydia or gonorrhea
- Placement of urinary catheters or use of surgical instruments in your urethra during procedures
- Postinfectious inflammation, such as from recurrent gonococcal urethritis
- Urethral or prostate cancer
- Treatments involving radiation
Urethral strictures are more common in men, especially those over 55, but women can also experience this condition.
Urethral Stricture Symptoms
A weak or slow stream of urine is the most common symptom of a urethral stricture. Other symptoms can include:
- Straining to urinate
- Painful urination, a condition known as dysuria
- Urinary tract infections
- Inflammation of the prostate gland in men
In severe cases, the urethra can become so constricted that it completely blocks the urine flow. This can result in acute urinary retention, where one cannot void at all.
When this happens, urine builds up in the bladder, causing significant pain and discomfort. If left untreated, it can lead to serious complications, such as damage to the kidneys or a life-threatening infection.
Acute urinary retention is a medical emergency and requires immediate attention.
How Are Urethral Strictures Diagnosed?
If you have symptoms of a urethral stricture, it's essential to see a doctor. They may use several tests to diagnose the condition, including:
- Urine flow tests which measure the speed of your urine stream
- Post-void residual urine test to check how much urine remains in your bladder after you urinate
- An x-ray procedure that uses a contrast dye to identify the location and length of the stricture
- A procedure called a cystoscopy, where a tiny camera is inserted into your urethra to inspect the stricture visually
Treating Urethral Strictures
Management and treatment involve careful consideration of both the severity and location of the narrowing. Each of these treatments comes with its own benefits and risks, and your doctor will work with you to choose the most appropriate procedure. Common treatment options include:
- Urethral dilation. A procedure where the urethra is gradually widened using special instruments to stretch the narrowed area. This can provide temporary relief but may need to be repeated.
- Internal urethrotomy. A minimally invasive surgery where a scope and specialized tools are used to remove scar tissue, opening up the narrowed section of the urethra.
- Surgical reconstruction is called urethroplasty. In more severe cases, surgery may be required to remove the scarred section and reconstruct the urethra. This offers a more permanent solution.
In some cases, especially with acute urinary retention, a thin, flexible tube called a catheter may be inserted to bypass the stricture and allow urine to drain from the bladder.
Your recovery time will vary depending on the type of treatment you receive. Less invasive treatments may allow you to feel better within a few days, while surgical options could require a recovery period of up to eight weeks.
What If I Have Symptoms?
Living with an untreated urethral stricture can lead to serious, even life-threatening complications, such as kidney failure or severe infections.
If you notice symptoms of a urethral stricture, particularly if they come on suddenly, seek medical care as soon as possible. Early intervention can prevent complications and help you and your doctor manage your condition effectively.
FAQs
1. Can I prevent a urinary stricture?
You can lower your risk by wearing protective gear, like an athletic cup, during sports and physical activities. Practicing safe sex with condom use and completing prescribed antibiotics for infections also helps reduce your chances. While not all strictures can be prevented, these steps can make a difference.
2. Can women get urethral strictures?
Yes, although urethral strictures are more common in men, women can also develop them, especially following trauma or infections.
3. What happens if a urethral stricture is left untreated?
If left untreated, urethral strictures can lead to serious complications, including kidney damage, severe infections, and the inability to urinate, which is a medical emergency.
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