A urethral stricture occurs when scar tissue forms in the urethra (tube that drains the bladder). The stricture blocks the urethra and may cause the urinary stream to slow to the point where the patient cannot urinate. Causes for urethral stricture formation include trauma ( sharp blow to the base of the penis), gonorrhea, or previous instrumentation of the urinary tract.
Diagnosis
Strictures are usually found during cystoscopy (passing a small telescope through the penis). The urologist may also order an X-ray study called a retrograde urethrogram (RUG) to further evaluate the extent of the stricture.
Treatment
urethral dilation - stretching open the urethra by passing sequentially larger tubes through the penis. Most likely to be successful on smaller strictures. May be performed under local anesthesia in the office.
visualized internal urethrotomy (VIU) - making an incision through the stricture by passing a small knife through the cystoscope. Most likely to be successful on small strictures. This is performed under anesthesia in the OR on an outpatient basis.
urethroplasty - an operation in which the narrowed portion of the urethra is removed and a new segment of urethra is created using penile or scrotal skin. Usually reserved for severe strictures or patients who failed dilation and VIU.
Urolume stent - a wire mesh tube is used to hold open the narrowed portion of the urethra. Most successful on smaller strictures.