Urethral strictures can lead to additional complications or problems if left untreated.
A urethral stricture is a narrowing of the urethra. The urethra is the tube that carries urine from the bladder and out of the body. This narrowing is due to the formation of scar tissue that can occur either within or near the urethra.
The stricture may be located anywhere along the length of the urethra, from the bladder to the urinary meatus.
There are various types of injuries, infections, or even inflammation that can result in the development of scar tissue in or around the urethra. While there may be an apparent cause to the development of a stricture, sometimes the event that initiated the scarring remains unknown. Scar tissue in this region is most commonly caused by injuries to the pelvis or the urethra. These can occur from events such as an automobile accident or prolonged use of a catheter. Scarring may also develop due to sexually transmitted diseases or urinary tract infections. Other factors may include past surgeries, cancer, or radiation therapy.
Most symptoms associated with urethral stricture involve the flow of urine. Those with scarring may notice a slower or decreased urine stream when voiding. Urine may spray out rather than form a stream. There may also be pain that occurs during urination. Those who suffer from strictures may also notice that it is difficult to completely empty the bladder. This could lead to an increased need to urinate or more frequent trips to the bathroom. Finally, those with scar tissue around the urethra may get more infections in the urinary tract, often with blood visible in the urine. In severe cases, individuals may have complete inability to void.
It is important to see a physician who specializes in urology to properly diagnose and treat this condition. Imaging scans, such as a antegrade urethrogram, will most likely be required in order for the specialist to determine the exact location and severity of the scar tissue. Once this information is available, the physician can help the patient to decide on an appropriate course of action.
If there is minimal scarring that leads to mild symptoms, a physician may wait to see if the problem progresses as long as there is little risk of complications. Moderate or serious cases may require some type of surgical intervention. The urethra may be dilated by stretching to alter the position of the scarring to increase the release of urine. The stricture may be cut to release the portion of the scar tissue that is constricting the flow of urine. It is possible that the physician will have to remove the entire portion of scar tissue, requiring the reconstruction of the urethra with the use of grafts.