Urethral Stricture

Symptoms can develop gradually and may become worse over time as the narrowing increases. Some people notice mild symptoms at first, while others develop more significant urinary problems.

Common symptoms of a urethral stricture include:

• weak or reduced urine flow

• difficulty starting urination

• spraying or a split urine stream

• straining to pass urine

• feeling unable to fully empty the bladder

• needing to urinate more often

• sudden urges to urinate

• pain or burning when urinating

• urinary tract infections (UTIs)

• blood in the urine

• pelvic or lower abdominal discomfort

• swelling of the penis in some cases

• urinary retention, where you cannot pass urine at all (complete urinary retention is considered a medical emergency and requires urgent treatment)

A urethral stricture develops when inflammation, injury, or infection causes scar tissue to form in or around the urethra. In some cases, the cause cannot be identified.

Common causes include:

Injury or trauma

Damage to the urethra or pelvis can lead to scarring. This may happen after:

• a fall or sporting injury

• pelvic fracture

• straddle injury, such as falling onto a bicycle bar

• trauma from a road traffic accident

Medical procedures

Some strictures develop after medical treatment or instrumentation involving the urethra. This can include:

• urinary catheter insertion

• cystoscopy

• prostate surgery

• radiation therapy

• previous urethral surgery

Infection and inflammation

Inflammation caused by infection can damage the urethra and lead to scar tissue formation. Possible causes include:

• sexually transmitted infections (STIs)

• recurrent urinary tract infections

• inflammation of the urethra (urethritis)

Other causes

Less commonly, urethral strictures may be linked to:

• inflammatory skin conditions such as lichen sclerosus

• previous cancer treatment

• congenital abnormalities present from birth

Some factors can increase the likelihood of developing a urethral stricture. These include:

• previous catheter use

• repeated urinary infections

• previous surgery involving the urinary tract or prostate

• pelvic injury or trauma

• a history of STIs

• inflammatory conditions affecting the genital area

• prior radiation treatment to the pelvis

At Welbeck, our consultant urologists provide a thorough assessment to identify whether you have a urethral stricture and determine the severity and location of the narrowing.

During your consultation, your specialist will ask about your symptoms, urinary habits, medical history, and any previous injuries, infections, or procedures involving the urinary tract. A physical examination may also be performed.

In some cases, your consultant may suspect a urethral stricture based on your symptoms alone. However, further investigations are often needed to confirm the diagnosis and plan the most effective treatment.

Tests may include:

• urine tests to check for infection or blood

• uroflowmetry, which measures the speed and strength of your urine flow

• bladder ultrasound to assess whether urine remains in the bladder after urination

• cystoscopy, where a thin camera is passed into the urethra to examine the narrowing

• retrograde urethrogram, a specialised X-ray using contrast dye to show the location and length of the stricture

• MRI scan in more complex cases

These tests help your consultant decide which treatment option is most suitable for you.

It’s not always possible to prevent a urethral stricture, particularly if it develops after an injury or a necessary medical procedure. However, some steps may help reduce your risk.

These include:

• seeking prompt treatment for urinary infections

• practising safer sex to reduce the risk of STIs

• avoiding trauma or injury to the pelvic area where possible

• following catheter care advice carefully if you need a urinary catheter

• attending follow-up appointments after urinary tract surgery or procedures

Early assessment and treatment of urinary symptoms may also help reduce the risk of complications from an untreated stricture.

Without treatment, a urethral stricture can lead to ongoing urinary problems and other complications. Most complications can be managed effectively when the condition is diagnosed early.

Potential complications include:

• recurrent urinary tract infections

• bladder stones

• urinary retention

• bladder damage caused by long-term pressure

• kidney problems in severe cases

• abscess formation around the urethra

• reduced quality of life due to urinary symptoms

Some men may also experience problems with ejaculation or sexual function, particularly if the stricture is severe or longstanding.

Treatment for a urethral stricture depends on the severity, location, length of the narrowing, and your symptoms. Your consultant will recommend the most appropriate option for your individual needs.

Treatment options may include:

• observation and monitoring for very mild strictures with minimal symptoms

• Optilume balloon dilatation – a minimally invasive treatment that combines balloon dilatation with a drug-coated technology to open the narrowing and help reduce the likelihood of scar tissue reforming

• urethrotomy, a minimally invasive procedure that uses a small instrument to cut the scar tissue and widen the urethra

• catheter placement to relieve urinary retention

• urethroplasty, a surgical reconstruction of the urethra used for longer or recurrent strictures

• treatment of underlying infection or inflammation

• intermittent self-catheterisation in some cases to help keep the urethra open

Urethroplasty is often considered the most effective long-term treatment for more complex or recurrent strictures. Your consultant will explain the benefits, risks, and recovery expectations of any recommended procedure.

At Welbeck, our urology specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if needed to ensure you receive the treatment you need as quickly as possible, all under one roof.

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.