A urethral stricture is a narrowing of the urethra. The urethra is the tube that carries urine from the bladder to the outside. A narrowing of the urethra can have various causes, including infection, injury, inflammation or scarring. If you notice signs or symptoms of urethral stricture, it is important to see a doctor for appropriate assessment and treatment. If left untreated, strictures in men can lead to serious complications such as bladder and kidney damage, infection or infertility.
Our experts on the topic of urinary constriction
The choice of treatment depends on factors such as the location and length of the narrowing, the patient's health and their preferences. An experienced urologist can help with the selection.
What causes a urethral stricture?
Necessary medical interventions
The majority of diagnosed urethral strictures are acquired. Around 45% occur as a result of necessary medical interventions during which treatments such as cystoscopies or catheter insertion can cause injury or pressure damage to the urethra.
(Minor) traumas
The proportion of strictures whose cause cannot be clearly established is around 30%. Most of these cases are due to (minor) trauma that occurred some time ago, such as long-term strain on the perineum while cycling.
Symptoms and signs of a urethral stricture
The symptoms of a urethral stricture can vary depending on the severity of the stricture and individual factors. Here are some common symptoms that may indicate the presence of a urethral stricture:
Delayed onset of the urine stream
Weak urine stream
Dribbling of urine
Strong urge to urinate
Pain when urinating
Feeling of incomplete bladder emptying
If left untreated, strictures in men can lead to serious complications such as bladder and kidney damage, infections, impaired ejaculation and infertility. The stricture can lead to the bladder not emptying completely. This can lead to urinary tract infections or urine backing up into the kidneys, which, if prolonged, can cause permanent kidney damage or, in the worst case, even kidney failure. At alta uro, the most modern techniques are used to carry out the treatment.
Diagnosis and examination methods
A urethral stricture is diagnosed through a combination of a detailed consultation, physical examination and imaging procedures such as urethrography (X-ray examination of the urethra) and cystoscopy (bladder endoscopy).
Medical history and physical examination
Imaging techniques
Treatment options for a urethral stricture
Various forms of treatment are available, ranging from conservative or minimally invasive procedures to complex interventions. The aim of the procedure is always to alleviate the symptoms caused by the stricture and, if possible, to reduce the risk of the stricture recurring.
The recommended treatment in each case depends on several factors:
Your preference as a patient
Location (region) and length of your route
The cause of your stricture
All previous treatments you have received for your stricture
Your general health
Conventional procedures include dilation of the stricture (bougienage), endoscopic slits (internal urethrotomy) and open surgery techniques. Endoscopic treatments are less complex, but their long-term effectiveness is limited, which can lead to frequent follow-up procedures with diminishing results.
The choice of treatment depends on various factors, such as the location and length of the stricture, the patient's general health and personal preferences. An experienced urologist can assist the patient in choosing the most appropriate treatment method.
Diltation with a drug-releasing balloon
The drug-eluting balloon is a newer technology for the treatment of urethral strictures. It is a small, cylindrical balloon designed to simultaneously open the urethra and slow or stop the appearance of new scar tissue.
This treatment method is an effective alternative to conventional endoscopic stricture treatments and offers minimally invasive, immediate relief.
Detailed information about this new technology can be found here:
In this method, the constricted area of the urethra is carefully stretched with special instruments under local anesthesia or sedation. This can be done in a single session or in several sessions.
What are the advantages of this procedure?
Non-invasive, relatively simple procedure, can be performed on an outpatient basis.
What are the known risks and disadvantages?
Strictures may return and repeated dilatations may be required. There is also a risk of tissue trauma and bleeding.
Urethroplasty (urethroplasty)
This procedure involves surgically removing the narrowed part of the urethra and reconstructing the urethra with healthy tissue. There are various techniques, including the use of autologous tissue or artificial materials.
What are the advantages of this procedure?
Long-term solution with lower recurrence rate compared to dilation. Can be customized to meet the patient's needs.
What are the known risks and disadvantages?
More invasive than dilation, it requires a longer recovery time and may be associated with a higher risk of complications such as infection and wound healing problems.
Urethral stents
A urethral stent is a small tube that is inserted into the urethra to keep it open. It is often used as a temporary solution, especially in patients who are not suitable for other procedures.
What are the advantages of this procedure?
Minimally invasive, can be used for short-term relief of symptoms.
What are the known risks and disadvantages?
Infections, irritation of the urethra, foreign body sensation, difficulty urinating, displacement of the stent and the need for regular monitoring and possibly repeat procedures.
Endoscopic slit (internal urethrotomy)
Urethrotomy or urethral slitting is an endoscopic procedure for the treatment of strictures. An endoscope is inserted into the urethra under visualization and the stricture is opened with a small incision.
What are the advantages of this procedure?
Minimally invasive procedure compared to open surgery, quick recovery, short hospital stay.
What are the known risks and disadvantages?
Burning sensation when urinating in the first few days, blood in the urine, risk of recurrence of a stricture.
Prevention of urethral strictures
Urethral stricture prevention focuses on minimizing potential causes and reducing the risk of injury or infection in the genital area. Here are some measures to prevent urethral strictures:
Avoidance of injuries
Safe sexual practices
Regular medical examinations
Caution with medical interventions
FAQs
What is a urethral stricture?
A urethral stricture is a narrowing or blockage in the urethra that impairs the normal flow of urine.
What symptoms can indicate a urethral stricture?
Symptoms of urethral stricture can include pain or burning when urinating, a reduced urine stream, frequent urination and a feeling of incomplete bladder emptying.
What are the possible causes of a urethral stricture?
This can be caused by inflammation, injury, infection or scarring that narrows the urethra.
How is a urethral stricture treated?
Treatment may include dilation, catheterization, medication to reduce scarring or, in severe cases, surgery.
What complications can occur if a urethral stricture is left untreated?
Untreated strictures can lead to urinary tract infections, urinary retention and kidney damage.
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