A urethral (u-REE-thrul) stricture occurs when scarring narrows the urethra — 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.

  • 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 strictures, resulting in faster recovery with minimal scarring.
  • Experience. Mayo Clinic urologists and their teams are highly trained, often with additional specialty training to deal with complex urethral reconstructive procedures.

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.

Narrowing of the tube that carries urine out of the body (urethra) can be caused by the buildup of scar tissue due to:

  • Trauma or direct injury to the urethra or pelvis (pelvic fracture)
  • Intermittent or long-term use of a catheter, a tube inserted through the urethra to drain the bladder
  • Enlarged prostate or previous surgery to remove or reduce an enlarged prostate gland
  • Cancer of the urethra or prostate
  • Sexually transmitted infections

Stricture is more common in males than females because of the longer urethra.

Signs and symptoms of urethral stricture include:

  • Slowing of your urine stream, which can happen suddenly or gradually
  • Urine leakage or dribbling after urination
  • Difficulty, straining or pain when urinating
  • Increased urge to urinate or more frequent urination
  • Swollen penis
  • Blood or discharge from the penis
  • Pain in the pelvis or lower abdomen

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Specialists in urology at Mayo Clinic in 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.

Specialists in urology at Mayo Clinic in 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.

Specialists in urology at Mayo Clinic in 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.

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
  • Cystoscopy — examines your urethra and bladder using a thin, tube-like device fitted with a lens (cystoscope) to view these organs

Corrective treatment is only necessary 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 and relieve pain — in the case of a complete blockage — is the usual first step in treatment. Self-catheterization is an option if you're diagnosed with a short stricture. Simply inserting a catheter may correct and open the urethra, if done periodically.
  • Urethroplasty. Urethroplasty surgically removes the narrowed section of your urethra or enlarges it. The recurrence of strictures after urethroplasty is low.
  • Endoscopic internal urethrotomy. 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.
  • 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 opening. This outpatient procedure may be an option if you have recurrent strictures.
  • 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.

See a list of publications by Mayo authors on urethral strictures on PubMed, a service of the National Library of Medicine.

Nov. 20, 2012