What are the other names for this Condition? (Also known as/Synonyms)

• Anterior Urethral Stricture
• Posterior Urethral Stricture
• Urethral Obstruction

What is Urethral Stricture? (Definition/Background Information)

• Urethral Stricture is a narrowing of the urethra, usually due to prior injury or infection. This blocks the flow of urine out of the body and can lead to various complications
• The urethra is the tube which drains urine out of the body from the urinary bladder. A stricture is a narrowing of the tubular structure
• Urethral Strictures are seen more often in men than women. It can present difficulties while urinating, blood in the urine (and semen), abdominal pain, and even urinary incontinence
• A treatment of Urethral Stricture may involve cystoscopy, surgical procedures, such as urethroplasty, and the placement of a catheter (if necessary)
• In a majority of cases, Urethral Stricture can be treated completely, and the prognosis is generally good. Acute cases in the absence of suitable treatment may cause renal injury

Who gets Urethral Stricture? (Age and Sex Distribution)

• Urethral Stricture can occur in individuals of any age
• Both males and females are affected; although, males are more at risk for this condition than females
• This condition is observed worldwide and there is no racial or ethnic predilection noted

What are the Risk Factors for Urethral Stricture? (Predisposing Factors)

The risk factors for Urethral Strictures may include:

• Sexually transmitted infection (STIs), especially individuals with multiple infections
• Procedures that are performed to place a catheter into the urethra
• In men, benign prostatic hyperplasia, resulting in an enlarged prostate gland
• Penile implants
• Any injury or fracture sustained to the pelvic area (straddle injuries)
• Repeated occurrence of urethritis i.e., swelling and irritation that is caused in the urethra
• Scar tissue formation due to surgery to correct a congenital condition called hypospadias (predominantly on young boys) in which the urethra is underdeveloped
• Tumors, in or near the urethra
• In women, frequent and/or poorly-treated urinary tract infections
• Radiation therapy to the pelvic region

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Urethral Stricture? (Etiology)

A narrowing or constriction of the urethra may occur from several factors or underlying medical conditions. The possible causes of Urethral Strictures may include:

• Inflammation or scars that are the end result of any surgery, disease, or injury
• Tumor that occur around or within the proximity of the urethra
• Certain medical procedures involving the pelvic region

What are the Signs and Symptoms of Urethral Stricture?

The signs and symptoms of Urethral Stricture may be slightly different for men and women and may include:

• Blood discharge in the urine
• In men, blood in the semen (or hematospermia)
• Decreased or no urine output
• Slow urine steam, spraying of urine stream
• Experiencing difficulties while urinating, inability to urinate (which is a medical emergency)
• Dysuria or pain experienced while urinating
• Discharge from the urethra
• Frequent and urgent sense of urination
• Incontinence: Accidental leaking of urine from the urethra
• Pain in the lower abdomen and pelvic region
• Swelling of the penis with pain

How is Urethral Stricture Diagnosed?

The various exams and tests performed to diagnose Urethral Strictures may include:

Physical examination and medical history evaluation; a physical exam may reveal the following:

• Decreased urinary stream
• Urethral discharge
• Enlargement of the bladder
• Enlarged or tender lymph nodes in the groin
• Additionally, in men:
  • Enlarged and tender prostate
  • Hardness in the under surface of the penis
  • Swelling and redness of the penis

The following tests may be performed to confirm Urethral Strictures:

• Cystoscopy
• Post void residual volume (PVR)
• Retrograde urethrogram
• Tests for certain sexually-transmitted infections such as chlamydia and gonorrhea
• Urinalysis
• Urinary flow rate and culture

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Urethral Stricture?

Urethral Strictures may lead to the following complications:

• Total blockage of the urine flow, resulting in urinary retention and associated complications
• In acute cases, the condition may result in kidney damage
• Impotence in men
• Bleeding and infection, during treatment of the condition using invasive or probing methods
• Urethral Stricture recurrence
• Treatment complications

How is Urethral Stricture Treated?

A healthcare provider may address Urethral Stricture based on its severity. The treatment procedures may include the following:

• Cystoscopy, wherein an instrument is inserted to stretch the urethra after administering local anesthesia, to dilate or widen the urethra
• Surgery based on location and length of the stricture is undertaken by the healthcare provider when cystoscopy is generally ineffective
• Open urethroplasty may be adopted for strictures that are long. This surgical procedure involves removal of the diseased parts and reconstruction of the region. The results of the procedure may depend on the following parameters:
  • Size - dimensions of the stricture
  • Location
  • Number of treatments attempted to treat the stricture
  • The expertise of the surgeon
• When a patient is unable to urinate, a suprapubic catheter may be placed as an emergency treatment measure, to drain the bladder through the abdomen
• A urinary diversion or appendicovesicostomy (Mitrofanoff procedure) may be performed that allows self-catheterization of the bladder through the abdomen walls

Currently, no drug treatment has been found to be effective in correcting this condition.

How can Urethral Stricture be Prevented?

The following measures may be considered to reduce one’s risk for Urethral Stricture:

• Treating benign prostate enlargements early and appropriately (in men)
• Undertaking prompt treatment for any underlying condition that are high risk factors for the condition
• Practicing safer sex methods will help in preventing Urethral Strictures that arise from sexually transmitted diseases

Quick and immediate medical attention for Urethral Strictures will help in preventing various complications related to the urinary bladder and kidneys.

What is the Prognosis of Urethral Stricture? (Outcomes/Resolutions)

• In most cases, a prompt diagnosis and early treatment of Urethral Strictures can help yield excellent results
• In some cases, repeat therapies/procedures must be performed to remove the scar tissue
• If Urethral Strictures results in renal failure, the prognosis maybe guarded

Additional and Relevant Useful Information Urethral Stricture:

• A hypospadias repair and urethroplasty procedure is performed to prevent the development of urinary-tract infections, or if there are problems with the flow of urine or semen

The following article link will help you understand hypospadias repair & urethroplasty procedure:

http://www.dovemed.com/article/hypospadias-repair/