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Urethral stricture is an abnormal narrowing of the tube that carries urine out of the body from the bladder (urethra).

Urethral stricture may be caused by inflammation or scar tissue from surgery, disease, or injury. It may also be caused by pressure from an enlarging tumor near the urethra, although this is rare.

Other risks include:

• A history of sexually transmitted disease (STD)
• Any instrument inserted into the urethra (such as a catheter or cystoscope)
• Benign prostatic hyperplasia (BPH)
• Injury or trauma to the pelvic area
• Repeated episodes of urethritis

Strictures that are present at birth (congenital) are rare. Strictures in women are also rare.

• Blood in the semen
• Bloody or dark urine
• Decreased urine output
• Difficulty urinating
• Discharge from the urethra
• Frequent or urgent urination
• Inability to urinate (urinary retention)
• Incontinence
• Painful urination (dysuria)
• Pain in the lower abdomen
• Pelvic pain
• Slow urine stream (may develop suddenly or gradually)
• Spraying of urine stream
• Swelling of the penis

A physical examination may show the following:

• Decreased urinary stream
• Discharge from the urethra
• Enlarged (distended) bladder
• Enlarged or tender lymph nodes in the groin (inguinal) area
• Enlarged or tender prostate
• Hardness (induration) on the under surface of the penis
• Redness or swelling of the penis

Sometimes the exam reveals no abnormalities.

Tests include the following:

• Cystoscopy
• Post-void residual (PVR) volume
• Retrograde urethrogram
• Tests for chlamydia and gonorrhea
• Urinalysis
• Urinary flow rate
• Urine culture

Treatment usually results in an excellent outcome. However, repeated therapies may be needed to remove the scar tissue.

Urethral stricture may totally block urine flow, causing acute urinary retention. This condition must be treated quickly.

Call your health care provider if symptoms of urethral stricture occur.

Practicing safer-sex behaviors may decrease the risk of getting sexually transmitted diseases and urethral stricture.

Treating urethral stricture quickly may prevent complications such as kidney or bladder infection or injury.

Jordan GH, Schlossberg SM. Surgery of the Penis and Urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.

Frenkl T, Potts J. Sexually Transmitted Diseases. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 11.