Urethral Stricture

What is a urethral stricture?

A urethral stricture is a narrowing of your urethra. Your urethra is the tube through which urine (pee) leaves your body. If you have a penis, your urethra runs from your bladder to the opening at the tip of your penis (urethral meatus). If you have a vagina, the urethra runs from your bladder to the front of your vagina.

Many people with a urethral stricture will have increasing discomfort while peeing and a slow or weak stream. This can gradually develop and lead to pushing or straining to empty your bladder. In others, problems peeing may show up suddenly, without any prior problems, and require immediate care.

Another name for a urethral stricture is urethral stricture disease.

How common are urethral strictures?

Urethral strictures affect about 1% of people who have a penis. Urethral strictures are less common if you have a vagina.

What are the symptoms of a urethral stricture?

The most common sign of a urethral stricture is a weak pee stream. Symptoms of a weak pee stream may include:

• Straining to pee.
• Pain while peeing (dysuria).
• Urinary tract infection (UTI).
• Inflammation in your prostate gland (prostatitis).

If you have a severe urethral stricture, you may suddenly not be able to pee at all. This is acute urinary retention. Acute urinary retention is a medical emergency. Without treatment, pee can back up your urinary system and cause one or both kidneys to swell (hydronephrosis). It can also cause your kidneys to stop working (kidney failure).

What does a urethral stricture feel like?

It depends on the severity of your urethral stricture. You may feel like you have to pee a lot, even right after using the restroom. Or you may feel a sudden, uncontrollable need to pee. In some cases, it may even be painful.

What causes a urethral stricture?

The most common causes of a urethral stricture are chronic (long-term) inflammation or an injury that causes scar tissue. Scar tissue causes the urethra to become narrow, which makes it more difficult for pee to flow.

Scar tissue can gradually form from:

• An injury to your penis or scrotum (the pouch of skin behind your penis that holds your testicles).
• An infection, usually a sexually transmitted infection (STI), such as chlamydia.
• Placement of urinary catheters or surgical instruments in your urethra during surgery or other medical procedures.
• Urethral or prostate cancer.
• Radiation therapy.

Sometimes, the inflammation or injury to your urethra happens long before you notice a urethral stricture. In other cases, the stricture develops soon after a urethral injury.

Can you pee with a urethral stricture?

Most people can pee with a urethral stricture, but it may be uncomfortable or painful. You may not feel like you’re able to empty your bladder completely. You might not be able to pee at all if you have a severe urethral stricture. Seek medical help quickly if you feel like you have to pee but can’t.

Who do urethral strictures affect?

Anyone can get a urethral stricture. But it becomes more common if you have a penis and you’re older than 55.

How do you know if you have a urethral stricture?

Contact a healthcare provider if you have a slow or weak pee stream. They may order noninvasive tests to find issues you may have emptying your bladder, though they may not directly identify a urethral stricture. These tests may include:

• Urine flow tests. Urine flow tests measure the speed of your pee (flow rate) when you use the restroom.
• Post-void residual urine test (PVR). A PVR test uses imaging tests to determine how much pee remains in your bladder after using the restroom. Typically, your bladder is empty or nearly empty after you pee. But if you have a stricture, some pee may remain in your bladder.

Noninvasive tests can’t determine if a urethral stricture or another condition is affecting your ability to drain your bladder. If a provider suspects a stricture, they may order a retrograde urethrogram to identify and measure it. A retrograde urethrogram is a type of X-ray procedure. The provider will insert a contrast dye into your urethra. The dye helps the provider locate the stricture and its length.

The provider may also perform a cystoscopy. During a cystoscopy, they’ll insert a small, flexible scope with a camera at the end into your urethra. The cystoscope allows the provider to identify and locate a stricture. Before the procedure, they’ll insert a numbing medication into your urethra to reduce discomfort.

How do you fix urethral stricture?

Urethral stricture treatment may include:

• Urethral dilation. During this procedure, a urologist uses long, thin rods that gradually increase in thickness to open the stricture.
• Internal urethrotomy. An internal urethrotomy involves using a cystoscope with a small knife (scalpel) at the end. A urologist uses the cystoscope to cut away scar tissue.
• Urethral reconstruction. A urologist will remove the stricture and reconnect the healthy ends of your urethra.

How soon after treatment will I feel better?

It depends on what type of treatment you get. You may start to feel better a few days after less invasive urethral stricture treatment, such as a urethral dilation. It may take up to eight weeks to fully recover after surgery. A healthcare provider will give you a better idea of your recovery timeline according to their recommended treatment.

How do I prevent a urethral stricture?

You can’t prevent all causes of urethral strictures. But you can help prevent injuries to the pelvic area of your body by:

• Wearing a properly fitting athletic cup (jockstrap or athletic supporter) while playing sports or other high-impact activities.
• Applying a lot of lubricating jelly when you insert a urinary catheter.
• Avoiding STIs. You and/or your partner(s) should use condoms. If you suspect you have an STI, talk to a medical provider right away. Make sure you take your full course of antibiotics.

What can I expect if I have a urethral stricture?

With treatment, urethral strictures generally have a positive outcome. But scar tissue can redevelop, requiring multiple treatments. You’ll need follow-up appointments with a healthcare provider to ensure you’re healing properly and that scar tissue isn’t developing again.

Can I live with a urethral stricture?

Without treatment, a urethral stricture can cause life-threatening complications, including kidney failure and severe infections. Talk to a healthcare provider as soon as you can if you have symptoms of a urethral stricture, especially if the symptoms develop suddenly.

When should I see a healthcare provider?

See a healthcare provider if you have symptoms of a urethral stricture. Schedule regular appointments with a provider after treatment to ensure you’re healing properly and the stricture isn’t coming back. If you still have symptoms, they may recommend additional treatment.

When should I go to the ER?

Go to the nearest emergency room if you have any of the following symptoms:

• Inability to pee.
• Increased pain while peeing.
• Blood in your pee (hematuria).
• Signs of an infection, like a fever.

What questions should I ask a healthcare provider?

Questions you may want to ask your provider include:

• How do you know that I have a urethral stricture?
• What caused the urethral stricture?
• How big is my urethral stricture?
• How should I take care of myself while I have a urethral stricture?
• What treatment do you recommend?
• How often should I schedule follow-up appointments?
• What are the odds my urethral stricture comes back?

A note from Cleveland Clinic

A urethral stricture occurs when scar tissue develops in your urethra. It can affect anyone, but it occurs more often if you have a penis and are older than 55. It can also cause frustrating and even life-threatening problems, including trouble peeing. You don’t have to live with these problems, though. Talk to a healthcare provider if you have symptoms. They can open up the narrow area, which should relieve your symptoms.