Urethral Stricture

The urethra is the narrow tube that carries urine from the bladder to the outside of the body.

A urethral stricture occurs when scar tissue causes part of the urethra to become narrowed. This narrowing restricts the normal flow of urine, which can lead to bothersome and sometimes more serious urinary symptoms.

Urethral stricture treatment is available with our urologists in Charlotte, NC and West Columbia, SC.

Urethral scarring can happen for different reasons. Among the most common are:

• Injury or trauma to the pelvic region or perineum
• Prior infections, including sexually transmitted infections like gonorrhea or chlamydia
• Medical procedures that involve catheters, scopes, or instruments passing through the urethra
• Cancer treatments, such as prostate surgery or radiation

Sometimes, no clear reason for stricture development can be identified. And, although not every stricture can be traced back to a single cause, scar tissue is the unifying factor. Once present, it can gradually narrow the urethra and interfere with normal bladder emptying.

While men are far more likely to develop this condition, women can experience strictures too, usually after:

• Trauma
• Medical procedures
• Chronic inflammation

The symptoms you experience will usually reflect the degree of narrowing. Some people have mild difficulty urinating, while others face more serious blockages. Urethral stricture symptoms include:

• Weak urine stream
• Hesitancy
• Straining to start urination
• Feeling that the bladder is not fully emptied
• Recurrent urinary tract infections
• Burning or discomfort when urinating, known as dysuria

In severe cases, urine may be unable to pass through the urethra at all. This is known as acute urinary retention. It’s a medical emergency that requires immediate attention.

Urethral strictures and benign prostatic hyperplasia (BPH) can cause similar urinary problems, like a weak stream, hesitancy, or incomplete bladder emptying. However, they are not the same.

BPH is a noncancerous enlargement of the prostate gland that commonly occurs as men age. As the prostate grows, it can press on the urethra from the outside, narrowing the channel and making urination more difficult.

In contrast, a urethral stricture results from scar tissue inside the urethra itself, rather than pressure from an enlarged prostate. The underlying causes are different, and getting the right diagnosis matters.

A combination of your symptoms and specialized tests will be used to confirm the diagnosis. Depending on your situation, your doctor may recommend:

• A urine flow study, uroflowmetry, to measure how quickly urine leaves the bladder
• A post-void residual test to check how much urine remains after urinating
• Imaging studies, such as a retrograde urethrogram or voiding cystourethrogram to map the urethra
• A cystoscopy in which a thin scope with a camera is inserted into the urethra to see the narrowed area directly

These tests help determine the exact location, length, and severity of the stricture. This allows treatment to be tailored accordingly. The tests also help distinguish strictures from other conditions that mimic similar urinary symptoms, such as BPH or prostate cancer.

There are different ways to manage strictures depending upon factors such as:

• The length of the narrowing
• The degree to which the stricture affects urination
• A history of procedures or prior interventions

Common approaches include:

• Catheter placement. In emergencies, a catheter may be inserted temporarily to drain urine and relieve retention.
• Urethral dilation: Special instruments are used to stretch the stricture gently. This can relieve symptoms temporarily but often needs to be repeated.
• Direct visual internal urethrotomy (DVIU). A minimally invasive procedure where the scar tissue is cut to widen the urethra. While recovery is usually quick, recurrence is common.
• Urethroplasty. A reconstructive surgery that removes or repairs the scarred portion of the urethra. This option has the best long-term success for more severe or recurrent strictures.

Recovery time varies depending on the procedure. Less invasive treatments may allow you to return to normal activity within days. Surgical repair can involve several weeks of recovery. Because recurrence is a possibility, ongoing follow-up with your urologist is essential.

A weak urinary stream is often mistaken for a regular part of aging, but that isn’t always the case. Difficulty starting or straining to pass urine should prompt a medical evaluation.

A urethral stricture that goes untreated can lead to complications such as:

• Bladder stones
• Repeated infections
• Kidney damage
• Dangerous urinary retention

Persistent urinary symptoms should never be ignored. Early treatment relieves discomfort and protects your long-term urinary health.

1. Will a stricture go away on its own?

No. Because strictures are caused by scar tissue, they do not resolve without medical treatment. Intervention is needed to open the urethra and restore normal flow.

2. Can strictures be detected with a simple urine test?

Not directly. A urinalysis may show signs of infection or blood, but imaging or cystoscopy is usually required to confirm and measure the stricture.

3. Can strictures affect sexual function?

Yes. In some cases, strictures can cause painful ejaculation, blood in the semen, or difficulty maintaining erections. These complications are due to poor urinary flow and associated inflammation.

4. What is the long-term outlook after treatment?

Outcomes depend on the type of treatment. Dilation and DVIU may need to be repeated, while urethroplasty has the highest long-term success rate. With proper management and follow-up, lasting symptom relief is possible.

5. Where can I schedule a consultation?

Consultations are offered in Concord, Denver, Fort Mill, Gastonia, Huntersville, Mint Hill, Mooresville, Pineville, Rock Hill, Shelby, and West Columbia.

6. How do I get started? 

Schedule an appointment online.

All of our providers treat urethral strictures.