Urethral stricture, or narrowing of the urethra, is a condition that affects both men and women. However, it is more commonly observed in men because their urethra is anatomically longer and narrower. Women have a shorter and wider urethra. In women, the causes of urethral narrowing can include difficult childbirth and various types of trauma. Any inflammation of the urethra can lead to its hardening, swelling, and thickening of the surrounding tissues.
If the inflammatory process is treated in time and properly, narrowing may be avoided. However, advanced or neglected cases often result in urethral stricture.
Pelvic bone injuries are also extremely dangerous. In such fractures, the urethra may sometimes rupture, and during the healing process, scar tissue often forms, leading to narrowing. Falling on the perineal area also frequently results in scar formation.
Signs of Urethral Stricture:
- A thin and weak stream of urine
- Difficulty and interruption during urination
- Straining, sometimes accompanied by pain
- Retention of residual urine in the bladder
- Impaired kidney function
- Sexual dysfunction and depression
Urethral stricture is typically treated surgically.
Modern Treatment of Urethral Stricture:
Modern treatment for urethral stricture includes three types of interventions:
- For strictures up to 2 cm in length, the narrowed segment is excised, and the healthy ends of the urethra are stitched together (anastomosis).
- In cases of longer strictures, where the narrowing extends over a greater distance, plastic surgery (urethroplasty) is performed. The narrowed section of the urethra is removed, and reconstruction is done using tissue grafts taken from the inner cheek (buccal mucosa) or foreskin. This type of operation requires highly skilled surgical techniques and cannot be performed by just any surgeon—it demands virtuoso-level expertise.
- Endoscopic surgery – A special instrument is inserted into the urethral lumen to cut through the narrowed area. A catheter is then placed at the site until the tissue has fully healed. This procedure is much less invasive and generally easier for patients to tolerate. It is used whenever the degree of urethral narrowing allows for this method.
