Urethral stricture
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Definition
Urethral stricture is an abnormal narrowing of the tube that carries urine out of the body from the bladder (urethra).
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 pressure from an enlarging tumor near the urethra, although this is rare.
Other risks include:
A history of sexually transmitted disease (STD)
Any instrument inserted into the urethra (such as a catheter or cystoscope)
Injury or trauma to the pelvic area
Strictures that are present at birth (congenital) are rare. Strictures in women are also rare.
References
Jordan GH, Schlossberg SM. Surgery of the Penis and Urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.
Brill JR. Diagnosis and treatment of urethritis in men. Am Fam Physician. 2010 Apr 1;81(7):873-8.
McCormack WM. Urethritis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 106.
Review Date: 9/3/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Symptoms
Signs and tests
A physical examination may show the following:
- Decreased urinary stream
- Discharge from the urethra
- Enlarged (distended) bladder
- Enlarged or tender lymph nodes in the groin (inguinal) area
- Enlarged or tender prostate
- Hardness (induration) on the under surface of the penis
- Redness or swelling of the penis
Sometimes the exam reveals no abnormalities.
Tests include the following:
References
Jordan GH, Schlossberg SM. Surgery of the Penis and Urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.
Brill JR. Diagnosis and treatment of urethritis in men. Am Fam Physician. 2010 Apr 1;81(7):873-8.
McCormack WM. Urethritis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 106.
Review Date: 9/3/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Treatment
The urethra may be widened (dilated) during cystoscopy by inserting a thin instrument to stretch the urethra while you are under local anesthesia. You may be able to treat your stricture by learning to dilate the urethra at home.
If urethral dilation is not successful or possible, you may need surgery to correct the condition. Surgical options depend on the location and length of the stricture. If the stricture is short and not near the urinary sphincter, options include cutting the stricture via cystoscopy or inserting a dilating device.
An open urethroplasty may be done for longer strictures. This surgery involves removal of the diseased part followed by reconstruction. The results vary depending on the size and location, the number of treatments you have had, and the surgeon's experience.
In cases of acute urinary retention, a suprapubic catheter may be placed as an emergency treatment. This allows the bladder to drain through the abdomen.
There are currently no drug treatments for this disease. If all else fails, a urinary diversion -- appendicovesicostomy (Mitrofanoff procedure) -- may be done. This allows you to perform self-catheterization of the bladder through the wall of the abdomen.
Expectations (prognosis)
Treatment usually results in an excellent outcome. However, repeated therapies may be needed to remove the scar tissue.
Complications
Urethral stricture may totally block urine flow, causing acute urinary retention. This condition must be treated quickly.
Calling your health care provider
Call your health care provider if symptoms of urethral stricture occur.
References
Jordan GH, Schlossberg SM. Surgery of the Penis and Urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.
Brill JR. Diagnosis and treatment of urethritis in men. Am Fam Physician. 2010 Apr 1;81(7):873-8.
McCormack WM. Urethritis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 106.
Review Date: 9/3/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Prevention
Practicing safer-sex behaviors may decrease the risk of getting sexually transmitted diseases and urethral stricture.
Treating urethral stricture quickly may prevent complications such as kidney or bladder infection or injury.
References
Jordan GH, Schlossberg SM. Surgery of the Penis and Urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.
Brill JR. Diagnosis and treatment of urethritis in men. Am Fam Physician. 2010 Apr 1;81(7):873-8.
McCormack WM. Urethritis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 106.
Review Date: 9/3/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 9/3/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.