What is a urethral stricture?
A urethral stricture is a narrowing of the urethra, the tube that carries urine from the bladder to the outside of the body. This narrowing creates resistance to urine flow and can cause progressive symptoms, making urination difficult and affecting quality of life if not properly treated.
Most common causes
The causes of urethral stricture can be varied:
Previous urological surgery or endoscopic procedures
Repeated or prolonged urinary catheterization
Urinary tract infections or urethritis
Perineal or pelvic trauma
Congenital causes
In some cases, no clear cause is identified
Common symptoms
Symptoms usually develop gradually:
Weak or interrupted urinary stream
Difficulty starting urination
Need to strain to urinate
Sensation of incomplete bladder emptying
Recurrent urinary tract infections
Urinary retention in advanced cases
How is urethral stricture diagnosed?
Before deciding on treatment, a complete diagnostic evaluation is essential to determine the location and length of the stricture:
- Uroflowmetry: evaluates the strength and pattern of the urinary stream
Retrograde urethrography: key test to define the stricture
Cystoscopy: direct visualization of the urethra using a camera
Urine tests and blood work, if necessary
A proper diagnosis helps avoid repeating ineffective treatments.
Treatment options for urethral stricture
Treatment must be individualized based on the type of stricture, its length, and whether it has been previously treated.
- Urethral dilations
A simple procedure, but often with only temporary benefit. It may require repeated sessions and does not address the underlying problem.
- Endoscopic internal urethrotomy
A minimally invasive technique indicated for short, early strictures, with a risk of recurrence over time.
- Optilume balloon
The Optilume balloon combines:
Mechanical dilation of the urethra
Local delivery of an antiproliferative drug to reduce restenosis
It is a useful intermediate option for selected patients, between conventional endoscopic treatment and reconstructive surgery.
- Urethroplasty (reconstructive surgery)
This is the treatment with the highest likelihood of definitive cure, especially for long or recurrent strictures. It may require grafts of the patient’s own tissue, such as buccal mucosa, with excellent long-term results when properly indicated.
Key message for patients
Not all urethral strictures should be treated the same way. Repeating simple procedures may not be the best strategy. Specialized evaluation in reconstructive urology allows selection of the treatment with the highest chance of success.
Urology specialized in urethral stricture
At Arzoz Urology, we provide a comprehensive evaluation of urethral stricture disease for patients from Girona and around the world, using a specialized approach and modern techniques such as Optilume and reconstructive surgery when indicated.
Do you have symptoms or doubts? Request an appointment and we will guide you in a personalized way.
