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Symptoms of Urethral Stenosis
Straining or prolonged effort to empty the bladder. This happens because the narrowed passage creates resistance to urine flow. Over time, straining may also lead to bladder muscle fatigue and worsening symptoms.
One of the most common complaints. The stream becomes slow, split, or interrupted.
Because the bladder cannot empty fully, patients feel the need to urinate again soon after. Nocturia (waking multiple times at night) is especially disruptive to sleep and quality of life.
Inability to empty the bladder completely. Should acute urinary retention occur, the complete inability to pass urine is a medical emergency that requires immediate intervention.
Inflammation and increased bladder pressure can make urination uncomfortable or cause burning sensations.
Stagnant urine left behind in the bladder becomes a breeding ground for bacteria, leading to repeated infections.
Causes of Urethral Stenosis
Direct injury to the male urethra, such as from a pelvic fracture, straddle injury, or blunt perineal trauma, can damage urethral tissue. Long-term use of urinary catheters, or repeated insertion of scopes and surgical instruments, can irritate the urethra. Even necessary procedures for conditions, such as benign prostatic hyperplasia (BPH), may leave behind scar tissue.
Certain sexually transmitted infections (STIs) such as gonorrhea or chlamydia, as well as recurrent bacterial UTIs, can inflame and scar the urethra, sometimes leading to recurrent strictures.
Previous surgeries on the urinary tract can lead to scarring.
Radiation used for prostate cancer or pelvic cancers can damage the delicate lining of the urethra, resulting in inflammation and fibrosis that can develop into strictures.
Risk Factors for Urethral Stenosis
Chronic infections repeatedly inflame the urethral lining, leaving scar tissue that narrows the passage.
Procedures such as prostate resection, bladder tumor removal, or repeated cystoscopies increase stricture risk, particularly when performed near the prostatic urethra or urethral meatus.
Extended or repeated catheterization can cause damage and scarring.
Urethral Stenosis Investigations
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We discuss urinary symptoms, past infections, surgeries, or trauma. A targeted exam can sometimes reveal narrowing at the urethral opening or signs of bladder irritation.
Patients urinate into a specialized device that measures flow rate and pattern. A flattened or prolonged curve suggests obstruction at the urethra.
Cystoscopy: A thin scope inserted into the urethra allows direct visualization of the narrowing. This is one of the most definitive tools for diagnosing the location and severity of a stricture. This is usually done under local or light anesthesia to keep you comfortable.
Retrograde Urethrogram: X-ray with contrast dye to outline the urethra and identify the location and extent of the stricture.
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Urethral Stenosis Treatment & Management Options
Combines gentle dilation with a drug-coated balloon designed to reduce scar regrowth (restenosis).
Outpatient procedure involving a stepwise expansion of the narrowed passage using increasing dilator sizes. Symptoms may improve but can come back over time, so some patients need repeated dilations.
An endoscopic incision made in the stricture to widen the passage. This can relieve symptoms, but strictures sometimes recur and may later require urethroplasty.
Surgical reconstruction or replacement of the narrowed section of the urethra for severe or recurrent cases. This is the most definitive treatment for many strictures and aims to provide a long‑term solution, but it is a more involved surgery.
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