Urethral Strictures: What You Need to Know

Overview

The urethra is the tube that carries urine from the bladder out of the body through the penis. A urethral stricture happens when scar tissue forms, causing the urethra to narrow. This narrowing makes it harder for urine to flow, which can lead to uncomfortable symptoms and, in severe cases, kidney damage if left untreated. Urethral strictures are most common in men, though they can rarely occur in women.

Signs & Symptoms

Symptoms vary depending on how narrow the urethra has become. Mild strictures may cause only minor changes to urination, while severe strictures can block urine flow entirely. Common symptoms include:

• Weak or slow urine stream
• Straining to start urination
• Frequent urge to urinate, especially at night
• Pain or burning during urination
• Blood in the urine or semen
• Swelling or pain in the penis
• Leaking urine after urination
• Inability to empty the bladder fully (in severe cases)

Causes & Risk Factors

Urethral strictures form when the inner lining of the urethra is damaged, leading to scar tissue that narrows the passage. Common causes and risk factors include:

• Trauma to the urethra, such as from a pelvic injury, straddle injury (falling onto the groin), or long-term catheter use
• Sexually transmitted infections (STIs) like chlamydia or gonorrhea that cause urethritis (inflammation of the urethra)
• Past urological procedures, such as prostate surgery or cystoscopy (a scope used to look inside the bladder)
• Benign prostatic hyperplasia (enlarged prostate) that puts pressure on the urethra
• Radiation therapy to the pelvic area
• Congenital (present at birth) narrowing of the urethra, which is rare

Diagnosis

• Physical exam and review of your symptoms and medical history
• Urinalysis: A test of your urine to check for infection or blood
• Urethroscopy: A thin, flexible scope is inserted into the urethra to look for narrowings directly
• Urethrography: An X-ray with contrast dye injected into the urethra to map the location and length of the stricture
• Uroflowmetry: A test that measures how fast you can urinate, to assess how much the stricture is blocking flow

Treatment & Management

Treatment depends on the length, location, and severity of the stricture, as well as your overall health. Common options include:

Living With It

• Drink plenty of water throughout the day to keep urine flowing and reduce irritation to the urethra
• Avoid holding urine for long periods, which can increase pressure on the urethra
• Practice safe sex to reduce the risk of STIs that can cause urethral inflammation
• Follow your doctor’s instructions for any post-procedure care, such as taking prescribed medications or using a temporary catheter if needed
• Attend all follow-up appointments so your doctor can monitor for signs of recurrence