A urethral (u-REE-thrul) stricture occurs when scarring narrows the tube that carries urine out of your body. A stricture restricts the flow of urine from the bladder and can cause a variety of medical problems in the urinary tract, including inflammation or infection.
Narrowing of the tube that carries urine out of the body (urethra) can be caused by the buildup of scar tissue due to:
- Tissue damage from a urologic procedure using medical instruments inserted into the urethra, such as an endoscope for viewing urinary tract structures
- Intermittent or long-term use of a catheter, a tube inserted through the urethra to drain the bladder
- Trauma or direct injury to the urethra or pelvis, such as a pelvic fracture
- Enlarged prostate or previous surgery to remove or reduce an enlarged prostate gland
- Cancer of the urethra or prostate
- Sexually transmitted infections
Urethral stricture is more common in males than in females because males have a longer urethra.
Signs and symptoms of urethral stricture disease include:
- Slowing of your urine stream, which can happen suddenly or gradually
- Urine leakage or dribbling after urination
- Spraying of the urine stream
- Difficulty, straining or pain when urinating
- Increased urge to urinate or more frequent urination
- Blood or discharge from the penis
- Pain in the pelvis or lower abdomen
- Efficient care. Your Mayo Clinic urology care team can move you quickly from diagnosis to recovery, often within a few days of your initial visit. Team members coordinate all your care on the Mayo Clinic campus.
- Expertise. Highly skilled urologists at Mayo Clinic perform both minimally invasive and reconstructive surgical techniques to treat urethral stricture disease.
- Experience. 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 900 people with urethral stricture each year.
Mayo Clinic in Rochester, Minn., ranks No. 1 for urology in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., is ranked among the Best Hospitals for urology by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked high performing for urology by U.S. News & World Report.
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.
Specialists in urology at Mayo Clinic's campus in Phoenix/Scottsdale, Arizona, care for people who have urethral stricture.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Specialists in urology at Mayo Clinic's campus in Jacksonville, Florida, care for people who have urethral stricture.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Specialists in urology at Mayo Clinic's campus in Rochester, Minnesota, care for people who have urethral stricture.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Your doctor will ask about your symptoms and your medical history and conduct a physical exam. Your doctor may 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 is necessary only if your stricture causes problems. You'll need frequent follow-up exams for at least a year after treatment to ensure the stricture doesn't recur and that you remain free of infection.
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 may also recommend antibiotics targeted to treat an underlying infection, if one is present. Self-catheterization may be an option if you're diagnosed with a short stricture.
- Dilation. In this procedure, 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. Urethroplasty involves surgically removing the narrowed section of your urethra or enlarging it. The procedure may 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 strictures after urethroplasty is low.
- Endoscopic urethrotomy. During this procedure, your doctor inserts a cystoscope — a thin optical device — into your urethra. Instruments inserted through the cystoscope into the urethra remove the stricture or vaporize it with a laser. This surgical procedure offers 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 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.
See a list of publications by Mayo authors on urethral strictures on PubMed, a service of the National Library of Medicine.
Sept. 04, 2015
- Peterson A. Treatment of urethral stricture disease. http://www.uptodate.com/home. Accessed July 29, 2015.
- AskMayoExpert. Urethral stricture disease. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Urinary retention. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-retention/Pages/facts.aspx. Accessed July 30, 2015.
- Wein AJ, et al., eds. Surgery of the penis and urethra. In: Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed July 30, 2015.
- Wolter CE (expert opinion). Mayo Clinic, Scottsdale, Ariz. Aug. 10, 2015.
- Cook AJ. Decision Support System. Mayo Clinic, Rochester, Minn. April 22, 2015.
- Castle EP (expert opinion). Mayo Clinic, Scottsdale, Ariz. Aug. 17, 2015.