A urethral stricture is a scar-related narrowing of the urine passage.
Many patients undergo repeated dilatation or repeated endoscopic cuts. These may help in carefully selected short first-time strictures, but recurrent or longer strictures often need reconstructive planning.
Repeated temporary procedures should not delay definitive repair when urethroplasty is the better long-term option.
We commonly evaluate
- Weak urine flow
- Spraying of urine
- Straining
- Recurrent urinary retention
- Burning with poor stream
- Recurrent UTI
- History of catheterisation
- History of urethral injury
- Failed dilatation
- Failed DVIU
- Suprapubic catheter dependence
- Pelvic fracture urethral injury
- Lichen sclerosus-related narrowing
Evaluation may include
- Uroflowmetry
- Post-void residual urine
- Urine culture
- Retrograde urethrogram
- Micturating cystourethrogram
- Cystoscopy
- Review of previous dilatation, DVIU or catheter history
Treatment may include
- Observation in mild selected cases
- Dilatation or DVIU in carefully selected short first-time strictures
- Suprapubic catheter care
- Anastomotic urethroplasty
- Buccal mucosa graft urethroplasty
- Staged urethroplasty
- Perineal urethrostomy in selected cases
- Follow-up uroflowmetry and monitoring
