Urethral stricture care at Mayo Clinic

Your Mayo Clinic care team

Urologists at Mayo Clinic provide expert care for people of all ages who have urinary tract problems. You move quickly from diagnosis to recovery, often within a few days of your initial visit.

Doctors at Mayo Clinic provide comprehensive care. Your doctor takes the time to get to know you and work with you to provide exactly the care you need.

Advanced diagnosis and treatment

To make a diagnosis, your doctor will ask about your symptoms and your medical history and conduct a physical exam. Your doctor might recommend a number of tests to determine the cause, location and length of the urethral stricture, including:

  • Urinalysis — looks for signs of infection, blood or cancer in your urine
  • Urinary flow test — measures the strength and amount of urine flow
  • Urethral ultrasound — evaluates the length of the stricture
  • Pelvic ultrasound — looks for the presence of urine in your bladder after urination
  • Pelvic magnetic resonance imaging (MRI) — assesses whether your pelvic bone is affecting or is affected by your condition
  • Retrograde urethrogram — uses X-ray images to check for a structural problem or injury of the urethra as well as the length and location of the stricture along the urethra
  • Cystoscopy — examines your urethra and bladder using a thin, tubelike device fitted with a lens (cystoscope) to view these organs

Corrective treatment at Mayo Clinic is necessary only if your stricture causes problems. If you do undergo treatment, you'll need frequent follow-up exams for at least a year to ensure the stricture doesn't recur and that you remain free of infection.

Your treatment will depend on your situation. Treatment options at Mayo Clinic include:

  • Catheterization. Inserting a small tube (catheter) into your bladder to drain urine is the usual first step for treating urine blockage. Your doctor might also recommend antibiotics to treat an infection, if one is present. Self-catheterization might be an option if you're diagnosed with a short stricture.
  • Dilation. Your doctor inserts a tiny wire through the urethra and into the bladder. Progressively larger dilators pass over the wire to gradually increase the size of the urethral opening. This outpatient procedure may be an option for recurrent urethral strictures.
  • Urethroplasty. This involves surgically removing the narrowed section of your urethra or enlarging it. The procedure might also involve reconstruction of the surrounding tissues. Tissues from other areas of the body, such as your skin or mouth, may be used as a graft during reconstruction. The recurrence of urethral stricture after a urethroplasty is low.
  • Endoscopic urethrotomy. For this procedure, your doctor inserts a thin optical device (cystoscope) into your urethra, then inserts instruments through the cystoscope to remove the stricture or vaporize it with a laser. This surgical procedure offers a faster recovery, minimal scarring and less risk of infection, although recurrence is possible.
  • Implanted stent or permanent catheter. If you have a severe stricture and choose not to have surgery, you may opt for a permanent artificial tube (stent) to keep the urethra open, or a permanent catheter to drain the bladder. However, these procedures have several disadvantages, including a risk of bladder irritation, discomfort and urinary tract infections. They also require close monitoring. Urethral stents are often a measure of last resort and are rarely used.

Generally, whenever urethroplasty is possible for treating urethral stricture, doctors prefer that procedure over other surgical treatments. The conventional wisdom is that performing urethroplasty early during the course of treatment spares you from needing multiple endoscopic urethrotomies, if urethral stricture recurs.

Expertise and rankings

Experience

Highly skilled urologists at Mayo Clinic have vast experience in performing both minimally invasive and reconstructive surgical techniques to treat urethral stricture disease.

Urethral stricture expertise

Mayo Clinic urologists and their teams are highly trained, often with additional specialty training to deal with complex urethral reconstructive procedures. Mayo Clinic doctors treat more than 1,000 people with urethral strictures each year.

Nationally recognized expertise

Mayo Clinic in Minnesota has been recognized as the best Urology hospital in the nation for 2016-2017 by U.S. News & World Report. Mayo Clinic in Arizona is ranked high performing in the same report.

Learn more about Mayo Clinic's Urology department.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

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Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

Oct. 18, 2017
References
  1. Peterson A. Urethral strictures in men. https://www.uptodate.com/contents/search. Accessed June 14, 2017.
  2. Male urethral stricture: AUA guideline. American Urological Association. https://www.auanet.org/guidelines/male-urethral-stricture-(2016). Accessed June 14, 2017.
  3. Tritschler S, et al. Urethral stricture: Etiology, investigation and treatments. Deutsches Ärzteblatt International. 2013;110:220.
  4. Riggin EA. AllScripts EPSi. Mayo Clinic, Rochester, Minn. April 10, 2017.
  5. Castle EP (expert opinion). Mayo Clinic, Rochester, Minn. June 28, 2017.