What to Know About Urethral Stricture

Medically Reviewed by Minesh Khatri, MD on February 19, 2024
3 min read

Urethral stricture is scarring in the urethra, the tube that moves urine out of your body. The scarring blocks or narrows your urethra and makes it difficult to urinate. It can cause pain.

If left untreated, urethral strictures can lead to kidney stones, infections, and urinary tract complications. 

Urethral strictures are rarely seen in women. Men have longer urethras and urine has to travel farther. This leads to higher chances of urethral disease.

Urethral strictures may be caused by:

Trauma or injury. Injury to the urethra or pelvis is the most common cause of urethral stricture. A fall onto your scrotum or perineum, the space between your scrotum and anus, or a fracture in your pelvis can cause inflammation and scarring. In many cases, men hit in the genitals or pelvis develop a urethral stricture years later. 

Medical complications. Some procedures, treatments, and surgeries can cause scarring in your urethra and lead to a stricture. These often come from:

Infections. Sexually transmitted diseases like gonorrhea can cause infection and inflammation in your urethra, leading to scarring and stricture.

Inflammatory conditions. Some chronic inflammatory skin conditions like lichen sclerosus can also lead to urethral strictures. Lichen sclerosus usually affects your genitals and anus and causes patchy, white skin that’s thinner than normal.

Cancer. Prostate or urethral cancer or the surgeries to treat it can cause scarring in the urethra. 

Birth irregularities. Some people are born with irregular or improperly formed genitals or urinary structures. Boys who have hypospadias, where the urethra isn’t at the tip of the penis, might be more likely to have urethral strictures. 

About 30% of urethral stricture causes are unknown. 

The most common urethral stricture symptoms include:

Symptoms tend to get worse over time for many people. 

Your doctor will go over your medical history and do a physical exam. They’ll also do some imaging tests and procedures before diagnosing urethral stricture. These can include:

Urine culture. Your doctor will take a sample of your urine and test it for bacteria or other infections. 

Peak flow urine study. During this test, you’ll urinate into a special toilet that measures how fast your urine flows from your bladder to the end of your urethra. If you have a stricture, you’ll have a lower flow rate. 

Retrograde urethrogram. During this procedure, your doctor will insert a thin tube called a catheter into your urethra at the tip of your penis and inject a harmless contrast dye. Next, they’ll take X-ray scans of your lower pelvic and genital area. The dye helps your doctor see any narrow spaces on the scan.

Antegrade urethrogram. This procedure is similar to the retrograde urethrogram, except the dye is inserted into your bladder. An X-ray will show any narrowing at the first part of the urethra. These two procedures might be done together to help your doctor get a full picture of the urethra.

Urethroscopy. During this procedure, your doctor will insert a thin tube with a camera on the end into your urethra. This will help them see any strictures. 

Urethral stricture treatments involve minor procedures, open surgery, or treating underlying conditions like urinary tract infections or an enlarged prostate. There are no medications to treat urethral strictures.

Some common procedures include:

  • Urethra dilation, a procedure to widen the urethra
  • Urethrotomy, where they use a laser and scope to remove scar tissue 
  • Urethral reconstruction, an open surgery to cut out the scarring and then reconnect the urethra 
  • Urethroplasty, a surgery to rebuild the urethra with tissue from the penis or scrotum

Urethral stricture treatment generally helps, but the stricture can come back, which means you’ll need treatment again. If you’re having trouble urinating or other symptoms, make sure you talk to your doctor