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Urethral stricture: What causes it?

What causes urethral strictures? How are they treated?

- Hal / California

Mayo Clinic urologist Erik Castle, M.D., and colleagues answer select questions from readers.

Answer

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Illustration of urethral stricture Urethral stricture

A urethral stricture is a narrowing in any part of the urethra — the tube that drains urine from the bladder. This impairs normal urine flow. Urethral strictures occur primarily in men because they have a longer urethra than women do. Causes include:

  • Urethral injury, disease, catheterization or surgery that results in inflammation or scar tissue
  • Urethral infections, such as gonorrhea
  • Rarely, a tumor in the urethra

Strictures may also be present at birth (congenital), but this is uncommon. Signs and symptoms of a urethral stricture include:

  • Decreased urine flow
  • Incomplete emptying of bladder
  • Painful urination
  • Urinary tract infection
  • Blood in the urine

A doctor can confirm a diagnosis by:

  • X-ray with dye injection into the urethra
  • Cystoscopy, a procedure in which your doctor inserts a narrow tube (cystoscope) with a camera attached into the urethra

Treatment of urethral strictures may include:

  • Inserting a tube in the abdomen (suprapubic catheter) to drain the bladder for temporary, short-term relief
  • Dilating the stricture by inserting a narrow instrument into the urethra
  • Internal incision of the stricture via a cystoscope or endoscope
  • Placing a permanent catheter through the urethra to drain the bladder
  • Surgery to correct the condition (open urethroplasty)

The use of urethral stents was a promising development in the treatment of strictures. But such stents had poor long-term results. As a result, stents are now only rarely used in the treatment of urethral strictures.

Without appropriate treatment, the stricture will almost always recur.

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Nov 26, 2007