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Urethral Strictures

What is a Urethral Stricture?

A urethral stricture is a narrowing of the urethra caused by scar tissue or inflammation, restricting urine flow from the bladder. It can develop due to injury, infection, or previous medical procedures. Strictures can vary in severity, sometimes causing mild discomfort but in more serious cases leading to urinary retention and complications.

Risk Factors

Several conditions and factors can increase the risk of developing a urethral stricture, including:

  • Trauma or Injury – Direct injury to the pelvic region or perineum can lead to scar formation.
  • Urinary Catheters & Medical Procedures – Long-term catheter use or past surgeries involving the urethra can cause scarring.
  • Infections & STIs – Untreated urinary tract infections (UTIs) or sexually transmitted infections (gonorrhea, chlamydia) can contribute to inflammation and scarring.
  • Radiation Therapy – Previous radiation treatments for pelvic cancers may damage urethral tissue.
  • Congenital Abnormalities – Some men are born with a naturally narrow urethra, which may develop strictures over time.

Symptoms

Urethral strictures can gradually worsen, leading to symptoms such as:

  • Weak or slow urine stream
  • Straining to urinate
  • Frequent urinary tract infections (UTIs)
  • Pain or discomfort during urination
  • Incomplete bladder emptying
  • Spraying or splitting of the urine stream
  • In severe cases, urinary retention (complete inability to urinate, requiring emergency care)

Treatment (Urethroplasty, Endoscopic Surgery)

The best treatment approach depends on the severity and location of the stricture.

Urethroplasty (Open Surgical Reconstruction)

  • Gold standard treatment for longer or recurrent strictures.
  • Involves removing or reconstructing the narrowed portion of the urethra.
  • Often provides long-lasting results with a low recurrence rate.

Endoscopic Surgery (Minimally Invasive)

  • Direct Vision Internal Urethrotomy (DVIU) – A minimally invasive procedure where a small incision is made in the stricture using a laser or scalpel.
  • Best for shorter strictures but may have a higher chance of recurrence compared to urethroplasty.

Prevention

While not all urethral strictures can be prevented, certain precautions can reduce the risk:

  • Practice Safe Sex – Use protection to prevent STIs that may cause scarring.
  • Seek Prompt Treatment for UTIs & Infections – Early treatment can prevent long-term damage.
  • Minimize Catheter Use – When necessary, ensure proper catheter placement and care.
  • Protect the Pelvic Area – Avoid injuries from falls, accidents, or high-impact sports.

If you experience urinary difficulties or discomfort, consult a urology specialist for evaluation and treatment options. Early intervention can help prevent complications and improve long-term outcomes.