Urethral stricture (narrowing)

Overview

Scarring or swelling of the tube that carries urine out of your body (urethra) is the most common cause of urethral narrowing (stricture). The disease mainly affects men and is characterised by difficulty in passing urine. Sustained improvement can often only be achieved by surgery.

Symptoms

Main symptoms

The narrowing slows or blocks the flow of urine:

• Difficulty in passing urine
• Urine stream is thin, crooked, widely spread or split
• Dribbling after urination, involuntary release of urine (urinary incontinence)
• Increased urge to urinate but little comes out, frequent urination at night (excessive night-time urination)
• Urine can be bloody and pain can occur when urinating

Complications

• Bladder infection caused by residual urine in bladder
• Inflammation of the kidney (pyelitis) caused by recurrent bladder infections
• Inflammation of the prostate or epididymis (tube at the back of the testicles)

Causes and treatment

Causes

Urethral narrowing is caused by scar tissue that narrows the urethra. The following are possible causes:

• Inflammation or infection of the urethra
• Surgery (in particular transurethral operations, e.g. prostate surgery)
• Urinary catheter
• Radiation of pelvic area to treat malignant tumours
• For men, serious pelvic injury can damage the upper urethra and cause a narrowing scar
• Among older women, hormone deficiency (oestrogen deficiency) can cause the external genitalia to shrink
• Congenital (rare)

Further treatment by your doctor / in hospital

Possible tests

• Measurement of urine stream (uroflowmetry)
• X-ray after injection of contrast medium into urethra (urethrocystography)

Possible therapies

• Catheterisation (insertion of a hollow tube into the urethra to allow urine to drain from the bladder)
• Bladder cannulation (insertion of a tube into the bladder to drain urine)
• Operation (usually endoscopic, i.e. through the urethra)

What can I do myself?

Urethral stricture (narrowing) can’t be self-treated and should always be treated by a doctor.

When to see a doctor?

• If the urine stream becomes progressively weaker
• If urination is painful
• If you have the urge to urinate but urination is impossible (emergency!)

Synonyms

urethral stricture, bladder cancer, prostatic hyperplasia, prostate enlargement, prostate cancer