Common symptoms
- Slow, weak or spraying urine stream
- Straining to pass urine
- Taking a long time to empty the bladder
- Dribbling after passing urine
- Repeated urinary tract infections
- Inability to pass urine in severe cases
What is a urethral stricture?
The urethra is the tube that carries urine from the bladder out of the body. A urethral stricture is a narrowing of this tube caused by scar tissue. The narrowing slows the flow of urine and, if left untreated, can lead to infections, bladder problems and kidney damage.
Strictures are much more common in men because the male urethra is longer.
What causes a urethral stricture?
- Injury to the urethra or pelvis, such as a fall astride or a road accident
- Previous catheterisation or urological procedures
- Infections, including sexually transmitted infections
- Inflammatory skin conditions such as lichen sclerosus
- In some cases, no cause can be found
How is it diagnosed?
- Uroflowmetry, to measure the urine flow rate
- Ultrasound, to check how well the bladder empties
- Retrograde urethrogram (RGU) and micturating cystourethrogram (MCU), X-ray studies that show the length and position of the stricture
- Urethroscopy in selected cases
Treatment options
The best treatment depends on the length, location and cause of the stricture, and on whether it has been treated before.
- Optical internal urethrotomy (OIU): an endoscopic procedure, suitable for short strictures.
- Anastomotic urethroplasty: the narrowed segment is removed and the healthy ends joined, suitable for short strictures in specific locations.
- Buccal mucosa graft (BMG) urethroplasty: a graft from inside the cheek is used to widen longer strictures.
Reconstructive urology is an area of particular interest for Dr. Sai Bharath, and his published research has focused on outcomes after urethroplasty and on reducing pain during urethrotomy.
When to see a urologist
See a urologist if you notice your urine stream getting weaker over time, need to strain, or have repeated infections. Early assessment widens the treatment options.
Treatments offered
- Optical internal urethrotomy (OIU)
- Anastomotic urethroplasty
- Buccal mucosa graft (BMG) urethroplasty
- Urethral dilatation in selected cases
Frequently asked questions
What is the difference between urethrotomy and urethroplasty?
Urethrotomy (OIU) is a short endoscopic procedure that cuts the narrowed segment from the inside. It works best for short, first-time strictures, but strictures can come back. Urethroplasty is an open reconstructive operation that removes or widens the narrowed segment and has a much higher long-term success rate, especially for longer or recurrent strictures.
What is buccal mucosa graft urethroplasty?
In this operation, a small piece of the lining from inside the cheek (buccal mucosa) is used to widen the narrowed part of the urethra. The cheek heals on its own within a few weeks.
How long does the catheter stay after urethroplasty?
A urinary catheter is usually left for a period after urethroplasty to let the repair heal. The exact duration depends on the type of repair. Dr. Sai Bharath's own published randomised trial studied early versus late catheter removal after urethroplasty.
This page is general information and not a substitute for a consultation. Every patient is different, and the right treatment depends on an individual assessment.