Urethral stricture is much more common in males than females, likely due at least in part to the greater length of the urethra.

Potential causes include

• Prior trauma / injury. This may have occurred years before the problem became evident
• Infection, such as sexually transmitted diseases
• Congenital strictures
• Cancer (rare)

In many cases a cause is not known.

Potential symptoms of urethral stricture disease include:

• Blood in the urine
• Slow or decreased urinary stream
• Splaying of the urinary stream
• Dribbling after urinating
• Urinary tract infection in men

Your provider may perform any or all of the following to determine if you have a urethral stricture:

• History – questions about your current symptoms and past urologic history
• Physical exam
• Cystoscopy – an endoscopic exam of the urethra and bladder
• Retrograde urethrogram – liquid contrast is placed into the urethra and an xray is taken
• Other imaging studies such as an ultrasound exam may be done to further evaluate

There are a number of treatment options depending on the extent of scar tissue involved and the location:

• Urethral dilation – this treatment involves the sequential passage of gradually enlarging instruments called sounds. While this treatment is usually quite effective, the chance of recurrence is very high. Sometimes patients are taught to pass a catheter themselves periodically to keep the urethra open
• Urethrotomy – this is usually done under anesthesia and involves cutting the stricture open with an endoscopic knife or laser, passed through a cystoscope. A catheter is usually left in for a number of days after this. There is still a significant risk of recurrence
• Urethroplasty – This is an open surgical procedure that removes the scar tissue and reconstructs the urethra, sometimes with a graft. While more involved than the first two, the risk of recurrence of stricture disease after this operation is quite low

There are no medications to treat urethral stricture disease.

Because of the risk of recurrence of stricture disease after treatment, follow up with a urologist is recommended. This will generally involve a history and exam as well as additional tests such as urinalysis and a noninvasive flow study to monitor the strength of the stream. Occasionally additional tests such as xray and/or cystoscopy may be indicated.

If left untreated, urethral stricture disease can lead to significant problems including recurring infections, bladder problems and even kidney failure.