What Is a Urethral Stricture?
A stricture is a dense scar that occurs somewhere along the urethra. The urethra is the urinary channel that carries urine to the outside of the body.
Symptoms
Strictures often cause symptoms such as poor urinary flow, painful urination, retained urine, and painful ejaculation. One of the more common symptoms is urinary tract infection. If you feel you have symptoms or have been diagnosed with a uretheral stricture, the reconstructive urologists in our clinic can help you decide on solutions and treatment options for this condition.
Causes
The causes of a urethral stricture cannot always be found. Some of the common causes are:
- Trauma, either a pelvic fracture or a blow to the perineum,
- Serious infections of the urinary tract,
- Trauma from urinary catheter placement,
- Radiation,
- Scarring from urologic procedures, or
- Previous surgery for hypospadias.
Urethral Strictures in Men
Urethral strictures occur in about one of 200 men. Strictures can occur anytime in life and cause obstruction of the urinary flow. A stricture is a dense scar that occurs somewhere along the urethra.
Treatments can include internal treatment, such as:
- urethral dilation or
- direct vision internal urethrotomy.
We also offer surgical treatment, which is called urethroplasty.
Urethral Strictures in Women
A urethral stricture is a scar in the urinary channel (urethra) that women urinate through, which travels out of the vagina. Urethral strictures in women are very rare. We perform several urethral surgeries for strictures in women every year at University of Utah Health. This does not seem like many, but actually is a lot even for a large hospital like University Hospital. The incidence of strictures in women is only about 0.5% compared to men.
Many women have been treated with dilation of the urethral strictures over time and come to get surgery when the dilations are no longer effective or they have too much pain from the dilations. Another common problem that motivates women to do surgery is pain with urination or urinary tract infections.
Surgery for Stricture Treatment
A small surgery is done on the vagina to fix a urethral stricture (urethroplasty). The urethra is expanded through the scarred area using a small piece of the lining of the mouth (buccal graft). The surgery takes about two to three hours to perform and patients can leave the hospital the next day. The mouth heals very quickly after the surgery and the catheter is usually removed at three weeks after the surgery is complete.
Surgical Follow-Up
We see patients about every three to six months after surgery. We will have patients perform our flow test and will do a scope procedure where we look at the area of the stricture that has been fixed. If this is stable over time patients can come back and see us yearly.