Urethral Stricture

When you have to “go,” you do. It’s simple. Except when it isn’t.

When it’s hard or painful to urinate (pee), you realize a lot happens behind the scenes. And your urethra plays the starring role. It carries urine from your bladder out of your penis and into the toilet. Blood in your urine (hematuria) and frequent infections in your bladder or testicles could also be telltale signs of a urethral stricture (blockage) — a treatable condition that makes it hard to get urine through your urethra and out of your body.

If you’re finding it harder than usual to pee, the expert urology providers at Cleveland Clinic are here to help. We listen to your concerns, answer your questions and find out what’s causing your urethral stricture. Then, we’ll work with you to craft the best, most personalized treatment plan.

Why Choose Cleveland Clinic for Urethral Stricture Care?

Caring approach:

We know it might be uncomfortable to talk about having problems urinating. But finding ways to help you overcome those problems is what we do every day. So when you come to see us, we’ll listen carefully, answer your questions and work with you to find the best treatment for your needs. Meet our team.

Industry leaders:

Sometimes, a urethral stricture is so narrow that we have to do a procedure to treat the blockage. Our surgery team is globally recognized for offering the highest level of care for people who need reconstructive urologic treatment.

Minimally invasive options:

Cleveland Clinic has one of the largest groups of surgeons with experience in minimally invasive urologic treatments like nonsurgical (endoscopic) placement of special stents or using a robot to rebuild your urethra. Our team is at the forefront of all types of available treatments.

Innovation and research:

We’re always researching new ways to treat urologic conditions like urethral stricture. That means you’ll benefit from the latest treatment tools and methods. And you may be able to try these new treatments before they’re widely available through one of our clinical trials. Your provider can let you know if you qualify to participate.

Virtual visits:

We want your care to be convenient. That’s why we now offer virtual visits for some appointments. If you have an internet connection and smartphone, tablet or computer, you can talk one-on-one with your providers from the comfort and privacy of home.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Diagnosing Urethral Stricture at Cleveland Clinic

Urethral stricture most often starts from chronic (ongoing) inflammation from an infection or injury to your penis, scrotum or perineal area. This can cause scar tissue to form, making your urethra narrower and narrower.

When you have a narrowing in your urethra, trying to urinate can be uncomfortable. It can be hard to have a stream that’s normal for you. So, you might find yourself pushing or straining to get urine out. Sometimes you might not be able to urinate at all.

Other symptoms include blood in your urine, frequent infections of your testicles or bladder caused by a back-up of infected urine, or leaking urine due to your bladder being too backed up (overflow incontinence).

Urethral stricture usually happens gradually, but it can sometimes show up suddenly. And if it does, it needs immediate care.

What to expect at your first visit

It’s understandable if you’re feeling a bit uncomfortable when you come to your first appointment. But it’s important to remember that we talk about these things every day. And we may have the answers and treatment you need to feel more like yourself again.

So when you first meet with your provider, they’ll spend some time getting to know you. Your provider will listen carefully and ask questions, like:

What symptoms do you have?
When did they start?
Are they getting worse?
How do they affect your life?
What other health conditions do you have?
Have you had past injuries?

They’ll also answer any questions you may have. And they’ll do a physical exam. They may also order tests to help confirm the diagnosis.

You’ll likely start noninvasive testing, like a post-void residual urine test. While it can’t diagnose urethral stricture, this test lets us see how well your bladder empties. If your provider feels you may have urethral stricture, you may also have an X-ray or a cystoscopy, which helps us see inside your urethra.

Meet Our Urethral Stricture Team

Providers from different specialties work together to confirm your diagnosis and make sure you have the most personalized treatment for your needs and goals. Your care team may include:

Providers Who Treat Urethral Stricture

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.

Treating Urethral Stricture at Cleveland Clinic

The type of treatment you have will depend on what we learn from your tests. We try to keep treatment as minimally invasive as possible. Your provider might recommend:

Urethral dilation: If you have a short stricture, your care team may recommend this endoscopic procedure. Your provider will widen your urethra using special tools and a cystoscope (a camera that lets us see inside your urinary tract). Sometimes, a special balloon filled with a medication similar to those used in heart vessel procedures may be used as well.
Internal urethrotomy: After dilating your urethra, we’ll use a cystoscope and a different tool to cut through scar tissue and open the blockage.
Urethral reconstruction: If dilation or urethotomy doesn’t work, or your stricture returns, we may need to remove the scar tissue and either rebuild your urethra or reconnect the healthy parts. This procedure is called urethroplasty.

Once you complete treatment for urethral stricture, you’ll have regular visits with your urology care team to make sure everything looks good and that the stricture hasn’t come back. You may also have a catheter in place for a couple of days.

Taking the Next Step

Not being able to urinate like you used to can be nerve-wracking, frustrating and painful. It may also result in kidney failure or irreversible bladder changes in the long run. But it’s important to remember you don’t have to live with it — and you shouldn’t. When you have a urethral stricture, getting care as soon as possible can give you the best results for recovery. Our providers are here to help you feel comfortable taking the next step so you can urinate easier and feel better.