Urethral stricture

Definition

Urethral stricture is an abnormal narrowing of the urethra (the tube that releases urine from the body).

Causes, incidence, and risk factors

Urethral stricture may be caused by inflammation or scar tissue from surgery, disease, or injury. It may also be caused by external pressure from an enlarging tumor near the urethra, although this is rare.

Increased risk is associated with men who have a history of sexually transmitted disease (STD), repeated episodes of urethritis, or benign prostatic hyperplasia (BPH). There is also increased risk of urethral stricture after an injury or trauma to the pelvic region. Any instrument inserted into the urethra (such as a catheter or cystoscope) increases the chance of developing urethral strictures.

Congenital (present at birth) pediatric strictures are rare, as are true strictures in women.

Symptoms

• Dysuria (painful urination)
  
• Difficulty urinating
  
• Slow urine stream (may develop suddenly or gradually)
  
• Spraying of urine stream
  
• Decreased urine output
  
• Increased urinary frequency or urgency
  
• Incontinence
  
• Blood in the semen
  
• Pelvic pain
  
• Lower Abdominal pain
  
• Bloody or dark urine
  
• Discharge from the urethra
  
• Swelling of the penis
  
• Urinary retention
  

Signs and tests

A physical examination may reveal the following:

• Decreased urinary stream
  
• Enlarged or tender Lymph nodes in the inguinal (groin) areas
  
• Redness or swelling of the penis
  
• Urethral discharge
  
• Enlarged or tender prostate
  
• Distended bladder
  

Sometimes the exam reveals no abnormalities.

Tests include the following:

• Urinary flow rate may be measured
  
• Post-void residual (PVR) measurement
  
• Urinalysis
  
• Urine culture (if evidence of infection)