Urethral Stricture

  • Medical Author:
    Siamak N. 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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    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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What type of doctor treats urethral obstruction?

Most commonly, urethral strictures are managed by urologists, who are doctors with training and specialization in the urinary system.

How is urethral stricture diagnosed?

When the medical history, physical examination, and symptoms are suggestive of urethral stricture, additional diagnostic tests may be helpful in further evaluation. Urinalysis (UA), urine culture, and urethral culture for sexually transmitted diseases (gonorrhea, chlamydia) are some of the typical tests that may be ordered in this setting. Examination of the prostate and screening for prostate cancer (manual exam and measurement of prostate specific antigen or PSA) may also be done by the doctor.

Oftentimes, imaging and endoscopic studies are necessary to confirm the diagnosis and identify the cause of urethral strictures.

Are there any special tests for diagnosing urethral stricture?

The following are some common imaging and endoscopic tests in evaluating urethral stricture:

  • Ultrasound of the urethra
  • Retrograde urethrogram
  • Anterograde cystourethrogram
  • Cystourethroscopy

Ultrasound of the urethra is one of the radiologic methods in evaluating urethral stricture. An ultrasound probe can placed along the length of the penis (phallus) and determine the size of the stricture, degree of narrowing, and length of the stricture. This is a non-invasive method and usually does not require any special preparation.

Retrograde urethrogram is another radiology test to evaluate urethral strictures. This test basically entails placing a small urinary catheter in the last part of the urethra (closest to the tip of the penis). Approximately 10 cc of an iodine contrast material is slowly injected in the urethra via the catheter. Then, radiographic pictures are taken under fluoroscopy to assess any obstruction or impairment to the flow of the contrast material that can suggest urethral stricture. This test provides useful information about the location, extent, and size of any narrowing in the urethra as well as the shape of any possible abnormalities.

Anterograde cystourethrogram is a similar test but can only be done if there is a suprapubic catheter in place (a urinary catheter placed in the bladder through the skin in the lower abdomen). Iodine contrast is then injected into the bladder via the catheter and its flow out of the urethra is radiographed under fluoroscopy.

Cystourethroscopy is an endoscopic evaluation in which a small camera at the tip of a thin tube is inserted into the urethra for direct visualization of the lumen of the urethra. The tip of the urethral opening is cleansed, and local lubricant and anesthetic gels are applied for comfort. Then the endoscope is inserted into the urethra and bladder. Any anatomical or structural abnormalities will be detected, and a biopsy can be obtained at the same time if necessary.

Medically Reviewed by a Doctor on 4/15/2015

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