The narrowing of the urethra, which functions as the conduit for urine from the bladder out of the body, can manifest at any point along its length, spanning from the bladder to the tip of the penis in males. This constriction can give rise to a range of urinary issues.

Symptoms

Patients with urethral stricture often experience weakened urine flow, difficulty urinating, recurrent UTIs, frequent urges to urinate (especially at night), and pain during urination or ejaculation.

Causes

Urethral stricture can be caused by trauma, infections (STIs or UTIs), certain medical procedures (like urethral surgery or repeated catheterizations) or occur spontaneously (idiopathic).

Diagnosis

• Medical history and physical examination.
• Uroflowmetry: The test measures the rate of urine flow.
• A cystoscope, either flexible or rigid, is introduced into the urethra to observe the stricture, determining its location, length, and severity.
• Imaging tests such as ultrasound, retrograde urethrogram, or magnetic resonance imaging (MRI) may be performed to evaluate further the stricture and its effects on the urinary tract.

Treatment

• Dilation: Stretching the narrowed urethra using progressively larger dilators.
• Urethrotomy: Cutting open the stricture with a knife or laser inserted through a cystoscope.
• Urethroplasty: Surgical removal of the strictured segment and reconstruction using tissue grafts or flaps.
• Self-catheterization: Some patients may need to self-catheterize intermittently to maintain urethral patency post-treatment.

Complications of urethral stricture include recurrence, urinary retention, and urinary incontinence, which can impact health and quality of life, necessitating close monitoring and appropriate management.

Prevention

To prevent urethral strictures, practice safe sex and avoid unnecessary catheterizations to reduce urethral trauma risk. Promptly treat STIs and UTIs to prevent urethral inflammation and scarring.

Identifying and managing urethral stricture is essential for symptom relief, prevention, and improved quality of life. Personalized treatment options such as dilation, urethrotomy, urethroplasty, and self-catheterization cater to individual needs. Vigilant monitoring and follow-up are critical for effectively addressing recurrence and complications and optimizing patient outcomes.