How is urethral stricture diagnosed?

Non-invasive testing may identify issues emptying the bladder, but cannot definitively identify a stricture. The rate at which your urine flows can be measured by urinating into a collection device – slow flow on this test could be caused by blockage of the urethra or a weak bladder. The post-void residual volume (the amount of urine left in the bladder when you are done urinating) can be measured by doing an ultrasound scan of the bladder. Normally, the bladder is empty after urinating, but with a stricture, some urine may stay in the bladder. From non-invasive testing it isn’t possible to determine if these issues could be due to a stricture, enlarged prostate, weakened bladder or other problem.

If a urethral stricture is suspected, an imaging procedure will be needed to identify and measure it. One procedure is a retrograde urethrogram. This is an X-ray procedure that uses a contrast agent that is squirted into the opening of the penis. The contrast shows up on an X-ray film to locate the stricture and its length. Sometimes, you will be asked to urinate once the bladder is full so that the stricture can be recognized during the voiding process.

Cystoscopy is a procedure in which a small, flexible, camera called a cystoscope is inserted into the penis. This procedure allows your doctor to see inside the urethra. It is done in the doctor’s office and it typically takes five to 10 minutes. Before the procedure, lidocaine jelly (a numbing medication) will be inserted into your urethra, allowing the doctor to pass the cystoscope into your bladder with less discomfort.

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