The urethra is the tube that carries urine from the bladder to outside the body. A stricture is a buildup of scar tissue that causes a narrowing of the tube. This decreases the flow of urine. Signs of a stricture include spraying of your urinary stream, slow urinary flow, painful urination, or blood in your urine.
Most commonly, there is no obvious cause of a urethral stricture. Some factors that may contribute to form strictures include: pelvic trauma, sexually transmitted infections, damage from a urological procedure or catheter placement, and rarely cancer.
To diagnose a stricture, your urologist may perform either a urethroscopy or a retrograde urethrogram. A urethroscopy is a procedure where a small camera is placed into the urethra so the physician can visualize the problem internally. A retrograde urethrogram is an X-ray study where die is injected into the urethra to identify the location as well as the length of the stricture. Both of these procedures may be done in the office.
Treatment of the urethral stricture varies upon the location and length of the narrowing. Sometimes, if the stricture is short, an endoscopic procedure may be done to open the urethra called a direct vision internal urethrotomy or DVIU. An incision is made in the urethra and a catheter is left in place for a period of time to allow the urethra to heal over the catheter. This is a minimally invasive procure and can be done on an outpatient basis. If the stricture is longer or recurrent, a urethroplasty may be performed. In this procedure the portion of the urethra that is scarred is removed and the healthy urethra is sewn back together. Sometimes, if the stricture is too long the segment cannot be excised a graft or donor tissue is used to help repair the defect.
Have questions about urethral stricture disease or treatment options? Call us to schedule an appointment at 360-733-7687.