The urethra is a smooth, muscular tube through which urine is released from the bladder and leaves the body. Because the urethra has a narrow diameter (about as wide as a piece of macaroni), any constriction or narrowing in the tube, called a urethral stricture, can slow the flow of urine. If the constriction is severe, the bladder won’t empty completely, causing urinary retention. Chronic urinary retention can lead to urinary tract infections, bladder distention (swelling), incontinence, and even kidney damage. Urethral strictures are more common in men; in women, urethral strictures are rare.
WHAT ARE THE SYMPTOMS?
Symptoms may include:
- Painful urination;
- Difficulty urinating;
- Slow urine stream;
- Unusually frequent urination;
- Urinary urgency;
- Incontinence;
- Blood in urine or semen;
- Discharge from the urethra;
- Penis swelling; and
- Pain in the pelvis or lower abdomen.
CAUSES AND RISK FACTORS
Most urethral strictures arise from an injury to the urethra. Common causes of urethral stricture include:
- Sports-related traumas;
- Medical procedures that involve the urethra; and
- Infections related to sexually transmitted diseases (STDs).
DIAGNOSIS
First, the patient describes his or her symptoms and reports any past injuries or infections in the area of the urethra. The physician may then recommend diagnostic tests to verify a stricture, including:
- Urine flow rate (uroflowmetry);
- Cystocscopy or cystourethroscopy;
- Retrograde urethrography;
- Ultransonography; and
- Blood tests, urinalysis, and urethral culture.
TREATMENT APPROACH
Treatments include:
- Antibiotics;
- Urethral dilation;
- Internal urethrotomy;
- Stent placement; and
- Open surgical reconstruction.
