Urethral Stricture

Diagnosis

To diagnose a urethral stricture, a healthcare professional will ask about your symptoms, review your medical history, and perform a physical examination. Several diagnostic tests can help identify where the stricture is located, how long it is, and what might be causing it.

Common tests include:

• Urine tests: Used to check for signs of infection, blood, or cancer in the urine.

• Urinary flow test: Measures how strong the urine flow is and how much urine passes out.

• Urethral ultrasound: Determines the length of the stricture.

• Pelvic ultrasound: Evaluates whether urine remains in the bladder after urination.

• Pelvic MRI scan: Provides detailed images of the pelvic area to assess bone or tissue involvement.

• Retrograde urethrogram: An X-ray test that helps locate and measure the length of the stricture and detect injuries in the urethra.

• Cystoscopy: A procedure using a thin, lighted tube called a cystoscope to view the inside of the urethra and bladder.

Treatment

Treatment for urethral stricture depends on the cause, length, and severity of the condition. The main goal is to restore normal urine flow and prevent future complications.

Common treatment options include:

• Catheterization:
  A small tube called a catheter is inserted into the bladder to drain urine. Antibiotics may be prescribed if there is an infection. In some cases, people with short strictures may be taught self-catheterization.

• Urethral dilation:
  This outpatient procedure gradually widens the urethra using dilators. A thin wire is inserted first, followed by larger dilators to increase the urethral opening. It may be suitable for recurring or mild strictures.

• Urethroplasty:
  A surgical procedure that removes or enlarges the narrowed section of the urethra. Sometimes tissue grafts from other parts of the body, such as the mouth or skin, are used to reconstruct the urethra. The risk of recurrence after urethroplasty is low.

• Endoscopic urethrotomy:
  This minimally invasive procedure uses a cystoscope to access the urethra. A tool or laser is used to cut or remove the narrowed section. Recovery is typically faster, and the risk of infection is low, but the condition may return after treatment.

• Implanted stent or long-term catheter:
  For people who are not candidates for surgery, a stent can be placed to keep the urethra open or a long-term catheter may be used to drain urine from the bladder. These options require ongoing monitoring due to risks of irritation, discomfort, and urinary tract infections.

Each treatment plan is personalized based on the patient’s condition, goals, and overall health. Regular follow-up is essential to monitor healing and prevent recurrence.