Urethra

What is a urethra?

The urethra is the tube that lets urine leave your bladder and your body. If you were assigned male at birth, your urethra passes through your prostate and into your penis. If you were assigned female at birth, your urethra is much shorter. It runs from your bladder to open in front of your vagina.

What does the urethra do?

The urethra is part of your urinary system. This system is made up of your kidneys, bladder, ureters and urethra. Your kidneys clean your blood and produce urine, a waste product. From your two kidneys, two ureters move the urine to the bladder, where it’s stored until you urinate (pee). Urine leaves your body through a hole at the end of your urethra. That hole from the inside to the outside is called the urethral meatus. (The term ‘meatus’ refers to any opening from the inside to the outside.)

Where is the urethra located?

The urethra is a passageway located in your body’s pelvic region. The walls of the tube are thin and made up of epithelial tissue, smooth muscle cells and connective tissue.

The urethra has two different types of sphincters, or muscles that act as valves that open or close. There is an internal urethral sphincter, which is located at the point where the urethra leaves the bladder. There’s also an external urethral sphincter located in the pelvic floor. These muscles work together with the bladder to get urine out of your body.

How long is the urethra?

If you’re someone who’s been assigned female at birth, your urethra is about 1.5 inches (3 to 4 centimeters) long. If you’re someone who’s been assigned male at birth, your urethra is about 8 to 9 inches long (about 20 centimeters).

In the anatomy typically called male, there are three parts to the urethra:

• The prostatic urethra: The part of the urethra that carries seminal fluid through the prostate gland to produce the semen that will be ejaculated.
• The membranous urethra: The short part of the urethra that transports fluids through the pelvic floor.
• The penile urethra (also called the spongy urethra or the cavernous urethra): The longest piece of the urethra. This section extends the entire length of the penis and ends at the urethral meatus or the opening outside the body.

What are the common conditions and disorders that affect the urethra?

Issues with the urethra are more common in people who have urethral anatomy that is typically considered to be male.

• Urinary tract infections, including catheter issues: Urinary tract infections are very common. The tract can become infected at any point, including the urethra. The need for a urinary catheter is related to the development of catheter-associated urinary tract infections (CAUTIs).
• Urethritis, including nongonococcal urethritis (NGU): Urethritis refers to inflammation usually caused by an infection with gonorrhea. NGU is the term for urethritis that isn’t caused by gonorrhea.
• Urethral strictures: This happens when the urethra becomes narrower due to scarring. The narrowness may result in inflammation (swelling of the urethra), infections, pain with urination and difficulty emptying your bladder.
• Genitourinary vaginal fistulas: These happen when holes open up between your urinary system and your vagina or uterus.
• Injuries or damage to the urethra: These include things like gunshot wounds, blunt trauma injuries and injuries that happen when you try to put something up your urethra. These may cause bruises or leaking of urine into surrounding tissues.
• Urethral cancer: This cancer is very rare.

If you have a damaged urethra, you may have certain complications, including:

• Infection.
• Bleeding.
• Strictures.
• Urinary incontinence.
• Erectile dysfunction.

What are the common signs or symptoms associated with disorders of the urethra?

Here are some common signs or symptoms you might have if you have a medical condition involving your urethra.

• Pain or difficulty while urinating (dysuria) or being unable to pee.
• Blood in the urine (hematuria).
• Discharge from the urethra.

What are common tests to check the health of the urethra?

If your healthcare provider suspects you have a disorder of the urethra, they may order these types of tests:

• Urine tests: These tests examine your urine in a lab.
• Cystoscopy: This test lets your provider look into your urethra and bladder with a cystoscope (a small scope with a camera).
• X-rays and/or ultrasound: These imaging tests allow your provider to see bones and soft tissue. Ultrasound can help your provider see your kidneys and bladder.
• Retrograde urethrography: This test combines an X-ray with a contrast agent.
• Voiding cystourethrogram: This test also uses a contrast agent to show what happens when your bladder fills up and then when you void (pee).

What are some common treatments for disorders of the urethra?

If you do have a disorder involving the urethra, the treatment will depend on the disorder. Possible therapies include:

Medications

If you have an infection, your provider will put you on anti-infective medications, such as antibiotics. If you have something like urethral cancer, your provider may suggest chemotherapeutic drugs.

Procedures

Many urethral conditions require treatments as therapies. These treatments may include:

• Dilation: Your provider will try to expand the urethra by using cystoscopy and instruments like a balloon.
• Urethrotomy: Your provider will use cystoscopy and a cutting instrument to remove the ring of scar tissue.
• Urethroplasty or urethral reconstruction: Your provider will use tissue from elsewhere in your body to build or rebuild a urethra.
• Surgery to remove tumors.
• Radiation therapy.

What are some simple lifestyle changes/tips to keep your urinary tract, including your urethra, healthy?

One of the most important things you can do is drink enough fluids, preferably water. Other tips include:

• Don’t smoke or use tobacco products.
• Reduce the amount of alcohol and caffeine you drink.
• Find and maintain a healthy weight.
• Get regular physical exercise.
• Avoid getting constipated.
• Avoid holding your urine for too long. Use the bathroom when you need to.
• Empty your bladder completely.
• Urinate after you have sex.
• Wipe from front to back when you use the bathroom.
• Make sure your underwear is made of cotton.
• Don’t wear tight clothing (pants).
• Use protective clothing, like a jockstrap, if you participate in sports.

Review your medications, foods and choice of birth control with your healthcare provider if you have problems with your urinary tract. Some medications and foods can affect your urinary system.

A note from Cleveland Clinic

Your urethra is the hollow tube that allows urine, which is a waste product, to leave your body. While you can’t guarantee that it will stay healthy, you can do things that will help, like drinking enough water every day and not overdoing caffeine and alcohol. If you have pain while peeing or see blood in your urine, contact your healthcare provider.