Urethral Stricture disease affects the urethra or water tube that runs from the bladder and is used to expel urine. It occurs in males and females and is usually caused by trauma, repeated trauma, infections and in some cases the cause of the urethral stricture is not identifiable.

Symptoms

Symptoms of urethral stricture disease include a slowing of the urinary stream, incomplete bladder emptying, hesitancy and in some cases overactive bladder symptoms which may include frequency and urgency.

Diagnosis

A diagnosis of urethral stricture disease is made after consultation and examination, analysis of blood and urine tests as well as imaging modalities like an urethrogram or an MRI, and in some cases an ultrasound. In some cases a cystoscopy might be necessary.

Treatment

The initial treatment of a urethral stricture is usually a dilation (stretching of the stricture) or in some cases, incision of the stricture. The recurrence rate of urethral stricture disease after dilation or incision is fairly high and approaches 50% after the first attempt. If the stricture should reoccur and a second dilation is required, the recurrence rate approaches 80%.

Urethroplasty

Because the recurrence rate of urethral strictures is high, a urethroplasty is preferred as definitive management (long term management) of urethral stricture disease. Urethroplasty can be performed in different ways which includes excising all the scar tissue and joining the two ends of the urethra or incising the urethral stricture and augmenting the lumen of the urethra with buccal mucosa graft. Urethral Stricture disease is not a one size fits all condition and treatment needs to be tailored and adapted to a patient’s circumstances as well as the type of urethral stricture they have (the location and the degree of the stricture).