How a stricture announces itself
The stream weakens gradually over months, so most men adapt without noticing until the flow splits, sprays, or stops altogether.
- Thin, weak or forked stream, and straining to pass urine
- Taking much longer at the toilet than you used to
- Incomplete emptying and dribbling afterwards
- Repeated urine infections, or epididymitis
- Sudden inability to pass urine — retention
Causes
Common causes are previous catheterisation or endoscopic surgery, perineal or straddle injury, infection, and lichen sclerosus. Many strictures follow a catheter placed during an unrelated hospital admission years earlier.
Treatment — and why the first choice matters
Optical urethrotomy or dilatation is quick, endoscopic and gives immediate relief. It also has a high recurrence rate for anything but a short, single, thin stricture, and each repeat attempt lengthens the scar and makes the eventual reconstruction harder.
Urethroplasty excises or patches the diseased segment and has durable long-term success. For a long or recurrent stricture, going straight to reconstruction saves years of repeat procedures.
If you have had two or more dilatations and the flow keeps falling, ask specifically whether urethroplasty is an option for you.
Urethral Stricture Treatment — common questions
Can a urethral stricture be treated with medicine?
No. Scar tissue does not respond to medication. Treatment is either endoscopic or reconstructive surgery.
How is a stricture diagnosed?
Uroflowmetry, a retrograde urethrogram and sometimes cystoscopy. The urethrogram maps length and site, which decides the treatment.
Is self-dilatation with a catheter advisable?
It is sometimes used to hold a result after urethrotomy, but it is a holding measure, not a cure, and it is uncomfortable long term.
Will the stricture come back after surgery?
Recurrence after a well-performed urethroplasty is uncommon. After dilatation or urethrotomy it is common, which is the main argument for reconstruction in suitable cases.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains urethral stricture treatment in general terms; your own treatment plan depends on your reports and examination.