Urethral strictures occur when scar tissue develops in the channel that carries urine from the bladder out through the penis (the urethra). This scar tissue may be caused by injury, infection or from unknown reasons. Symptoms vary but may include a slow urine stream with prolonged urine time, discomfort with urination, blood in urine, spraying of urine and inability to empty the bladder completely. If severe enough a complete blockage may occur.
Treatment options range from simple techniques performed with a cystoscope to more complex reconstruction.
This involves the use of increasing larger instruments to widen the scar. Dilation is perfomed either in the office or the operating room with light anesthesia.
Cutting of the urethra via a cystoscope can be performed in a variety of ways. Sometimes a laser may be utilized in an attempt to keep the scar tissue from coming back. A short outpatient hospital procedure is necessary.
This is a metallic, permanent stent inserted through a cystoscope, that expands inside the urethra to keep the urine channel from narrowing. There are limited uses for a urethral stent (Urolume) but it may be indicated in a select group of patients. Patients are treated through the outpatient surgery suite.
Also called “urethroplasty”, reconstruction of the urethra is a surgical procedure that removes the unhealthy scar tissue to prevent it from coming back. Prior to performing urethral reconstruction, an x-ray of the urethra (retrograde urethrogram) is performed to determine the length and location of the stricture as these will determine the most appropriate type of urethroplasty. While reconstructive surgery is more complex than dilation or urethrotomy, it offers patients an opportunity to urinate without blockage and eliminate, or limit, the amount of procedures they will need in the future. Typically this surgery requires one night in the hospital.