Male Urethral Stricture

Urologists at Brigham and Women’s Hospital (BWH) specialize in problems of the genitourinary tract, including urethral stricture disease. This condition is characterized by a scar around the urethra which causes it to narrow and block the flow of urine. Urethral stricture results from inflammation, injury or infection. It is more common in men than women since their urethras are longer.

Urethral Stricture Topics

Symptoms of Urethral Stricture

There are many symptoms that may indicate urethral stricture. These include:

  • Painful urination
  • Slow urine stream
  • Decreased urine output
  • Spraying of urine stream
  • Blood in urine
  • Abdominal pain
  • Urethral discharge
  • Urinary tract infections in men
  • Infertility
Diagnosis of Urethral Stricture

Early detection is recommended to prevent serious kidney problems. Your urologist will conduct a thorough diagnostic evaluation which may include:

  • Medical and physical examination
  • Urethral imaging, X-rays or ultrasound.
  • Urethroscopy, a small telescope in the urethra, allows visual examination between the tip of the penis and the stricture.
  • Retrograde urethrogram injects contrast dye into the urethra at the tip of the penis to indicate the number, position, length and severity of the stricture.
  • Antegrade urethrogram allows visualization of entire urethra and stricture.
Treatment for Urethral Stricture

Your urologist will decide the best treatment option for you after evaluating the length, location and degree of scar tissue. Treatment may include:

  • Dilation, stretching the stricture using progressively larger dilators or a balloon on a catheter.
  • Urethrotomy, moving a cystoscope along the urethra to the stricture. A blade or laser on the cystoscope cuts the stricture, creating a gap in the narrowing.
  • Urethral Stent, placing a metallic stent into the urethra through the penis using a cystoscopic insertion tool. It expands within the stricture and prevents the urethra from closing.
  • Open surgical urethral reconstruction, surgery to remove the stricture and reconnect the two ends (anastomotic urethroplasty). Sometimes tissue is transferred to enlarge the segment (substitution procedures).
  • Anastomotic procedures involves cutting between the scrotum and rectum and inserting a catheter.
  • Substitution procedures:
    • Free graft procedure: Skin graft or cheek buccal mucosa may be used to repair longer strictures and enlarge the urethra.
    • Skin flap procedure: A long stricture with severe scarring may require a complex surgical procedure using flaps of skin from the penis.
    • Staged procedure: When tissue is not available for a skin flap procedure or a free graft. Multiple graft surgeries are done over several months.
What You Should Expect

You will receive a thorough diagnostic evaluation and receive clinically-proven treatment by a board-certified urologist who specializes in urethral stricture. Our goal is to alleviate symptoms so you can return to every life. Appointments are confidential and private.

Multidisciplinary Care

Brigham and Women’s Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your urethral stricture, you will be referred to an appropriate BWH physician for an evaluation.

Resources

Go to our online health library to learn more about urology diseases and tests.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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