Urethral Stricture

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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The urethra is the opening that allows urine to leave the bladder. In men, the urethra is a thin tubelike structure that starts from the lower opening of the bladder and traverses the entire length of the penis. In women, it is a shorter opening coming off the lower opening of bladder and is between 2.5 to 4 centimeters (cm) in length.

The urethra has a sphincter that is normally closed to keep urine inside the bladder. When bladder fills with urine, there are both voluntary and involuntary controls to open the urethral sphincter to allow urine to come out.

Urethral stricture refers to any narrowing of the urethra for any reason whether or not it actually impacts the flow of urine out of the bladder.

Any inflammation of urethra can result in scarring, which then can lead to a stricture or a narrowing of the urethra. Trauma, infection, tumors, surgeries, or any other cause of scarring may lead to urethral narrowing or stricture. Mechanical narrowing of the urethra without scar formation (developmental causes or prostate enlargement) can also cause urethral stricture.

Urethral stricture is significantly more common in men and boys compared to women and girls. This condition is considered rare in females.

The following are common causes of scarring or narrowing of the urethra:

• Trauma from injury or accidents with damage to the urethra or bladder (for example, falling on a frame of a bicycle between the legs, or a car accident)



• Pelvic injury or trauma



• Previous procedures involving the urethra (urinary catheters, surgeries, cystoscopy)



• Previous prostate surgery (TURP or transurethral resection of the prostate)



• Prostate enlargement



• Cancer of the urethra (rare)



• Infections of the urethra (sexually transmitted diseases or STDs, urethritis, gonorrhea, chlamydia)



• Prostate infection or inflammation (prostatitis)



• Previous hypospadias surgery (a congenital birth defect in which the opening of the urethra is on the underside of the penis instead of the tip)



• Congenital malformations of the urethra, which rarely can cause urethral stricture in children

According one study, about one-half of causes of urethral stricture are from medical procedures and manipulation of the urethra or nearby structures (surgeries, catheter insertion, etc.). In about one-third of cases, no identifiable cause was found.