Urethral stricture is a narrowing of the urethra caused by injuries, tumors, prostate surgeries, catheter use, STDs, and radiation therapy. This condition is more common in men, and changes in urinary flow and burning during urination are warning signs. Learn more.
Urethral stricture, a narrowing of the urethra caused by factors like injuries, surgeries, or infections, directly impacts the quality of life of those who experience it. Over time, this condition can lead to severe complications if left untreated.
In this article, we’ll explore what you need to know about the causes, symptoms, diagnosis, and treatments for urethral stricture, along with tips to prevent urethral issues.
Taking care of intimate health is essential, and the first step is information.
What is urethral stricture?
Urethral stricture is the result of a urethral tissue fibrosis—a type of scar tissue that can be acquired or congenital.
The most common causes of acquired stricture include:
- Blows or falls affecting the genital area;
- Tumors near the urethra;
- Pelvic fractures;
- Prolonged or incorrect catheter use;
- Injuries from urological surgeries, such as prostatectomy and radiation treatments.
Frequent urinary infections, urethral inflammation, and sexually transmitted diseases are also causes of urethral stricture.
In its congenital form, babies are born with a narrowing at the junction between the ureter (tube that carries urine from the kidneys to the bladder) and the renal pelvis (upper part of the kidney). It is believed that genetic and environmental factors, such as chemical exposure during pregnancy, are causes.
What are the symptoms of urethral stricture?
Symptoms of urethral stricture include:
- Reduced urine flow;
- Weak urinary stream;
- Urgency to urinate;
- Urinary incontinence;
- Painful urination, possibly with burning;
- Sensation of incomplete bladder emptying;
- Abdominal or pelvic pain;
- Frequent urinary tract infections, such as prostatitis;
- Blood in urine or semen;
- Dark urine;
- Urethral discharge;
- Swelling or pain in the penis;
- Urinary retention and kidney problems in severe cases.
Symptoms of congenital urethral stricture are similar, including abdominal pain, fever, frequent urinary infections, and even kidney issues.
Complications of untreated urethral stricture
When the urethra narrows, the bladder muscle exerts extra effort to release urine. This added strain worsens the situation, underscoring the need to visit a urologist at the first signs of symptoms.
In severe cases, it may become impossible to urinate. Urine buildup retains bacteria that would otherwise be expelled during urination, increasing the risk of urinary tract infections.
Failure to release urine also poses risks for pyelonephritis—a kidney infection caused by bacteria or microorganisms traveling from the urethra or bladder to the kidneys.
There are also complications specific to male urethral stricture. One of them is bacterial orchitis, an inflammation of the testicles caused by bacteria spreading from the urethra.
The prostate is also affected, as it is located beneath the bladder. With a narrower urethra, pressure builds on the bladder and prostate, which can lead to inflammation known as prostatitis.
Finally, erectile dysfunction is another consequence of untreated male urethral stricture. Difficulty achieving an erection may result from excessive bladder pressure on the blood vessels and nerves responsible for erectile function, or from the emotional stress caused by the condition.
How is the diagnosis made?
The diagnosis of urethral stricture involves tests such as urethrography, cystoscopy, and urethroplasty. Learn more:
1. Uroflowmetry
This evaluates urinary system function by analyzing data such as:
- Time to start urination;
- Maximum urine flow rate;
- Average urine flow rate;
- Time to reach maximum flow;
- Total urine expelled;
- Total urination time.
2. Urethrography
An imaging test that identifies urethral problems. Contrast dye is injected through a catheter inserted into the urethra to capture X-ray images.
3. Cystoscopy
Cystoscopy, also called urethrocystoscopy, is a minimally invasive imaging test that examines the bladder and urethra using a cystoscope, with the patient lying in a position similar to a gynecological exam.
4. Urethrocystography
An X-ray test using contrast dye to assess the bladder and urethra. The dye is injected through a catheter until the bladder is fully filled. Two X-rays are taken: one with the bladder full and another after the patient urinates.
Treatment options for urethral stricture
Urethral stricture can be treated based on the severity and the patient’s individual conditions, with significant recovery potential. Available treatments include:
1. Urethral dilation
This treatment gradually increases the urethra’s size. Performed under local anesthesia, the doctor uses specialized tools to reach the necessary diameter for urine passage. The number of sessions depends on the severity of the narrowing.
2. Urethrotomy
A procedure in which the doctor makes an incision in the urethra to create space. The patient uses a urinary catheter to drain urine during healing. In some cases, additional dilation sessions may be needed to ensure the urethra remains open.
3. Urethroplasty
In urethroplasty, also known as urethral stricture surgery, the doctor removes the affected portion, allowing healthy sections to naturally reconnect. If the affected area is extensive, reconstruction with skin grafts is required.
The procedure lasts 2 to 4 hours, potentially extending to 6 hours for severe strictures. Recovery takes 2 to 4 weeks, during which physical activities should be avoided.
How to prevent urethral issues
It is possible to prevent urethral stricture and other related problems. Here’s how:
- Stay hydrated: Drinking plenty of water helps dilute urine, flushing out toxins and keeping the urethra clean;
- Maintain hygiene: Clean the penis daily with water and mild soap during showers, wear cotton underwear, avoid tight clothing, and ensure the genital area remains ventilated to prevent infections;
- Don’t hold in urine: Retaining urine increases the risk of urinary infections because bacteria remain in the body longer;
- Urinate after sexual activity: This helps flush bacteria from the urethra that could cause urinary tract infections;
- Use condoms: To prevent friction in the genital area and protect against sexually transmitted diseases that can affect the urethra.
Recognize the signs and seek medical help
Urethral stricture can be treated, but it’s crucial to consult a urologist as soon as symptoms appear, such as a weak urine stream or painful urination with burning sensations. Early medical intervention increases the chances of effective treatment and better outcomes.
If you are concerned about men’s intimate health and want to learn more about preventing and treating urological issues, explore the resources available on the Dr. Paulo Egydio Blog. Discover valuable insights and tips for maintaining urological health.
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