The urethra is a narrow tube which carries urine outside of your body. When scarring serves to narrow that tube, the condition is known as a urethral stricture. The ailment is much more common in men then women for the simple reason that a man's urethra is so much longer.
The scarring that generates a urethral stricture may be caused by:
- Enlarged prostate or previous surgery to remove or reduce an enlarged prostate gland
- Tissue damage from a urologic procedure
- Intermittent or long-term use of a catheter
- Trauma or direct injury to the urethra or pelvis, such as a pelvic fracture
- Cancer of the urethra or prostate
- Sexually transmitted infections
The spectrum of severity depends upon the level of scarring, and can range from no symptoms at all up to complete urinary retention. Other symptoms may include:
- Urine leakage or dribbling after urination
- Spraying of the urine stream
- Difficulty, straining or pain when urinating
- Increased urge to urinate or more frequent urination
- Blood or discharge from the penis
- Pain in the pelvis or lower abdomen
Your urologist will likely test you extensively with any of these symptoms. Expect a urinalysis, urine culture and urethral culture – this last as a check for sexually transmitted diseases. He is also likely to exam your prostate and schedule a measurement of prostate specific antigens.
Additionally, imaging and endoscopic studies may be required, to confirm an earlier diagnosis. In addition to an ultrasound of the urethra, your urologist may order a retrograde urethogram, antergrade cystourethrogram, or a cystourethroscopy.
If your doctor diagnoses you with a urethral stricture, there is little he can do for you besides surgery or symptom control. He may perform a urethral dilation, in which thin rods of increasing diameters are gently inserted into the urethra from the tip of the penis in order to open up the urethral narrowing without causing any further injury to the urethra. Another technique is a urethrostomy, in which a small knife is passed through an endoscope inserted in your urethra and used to cut the stricture lengthwise. A third optionis a urethral stent placement, in which a closed tube is passed through your urethra and then opened. Finally, your doctor may opt for what is known as open reconstruction, procedures that involve opening the urethra surgically under general anesthesia to fix the stricture.