Urethral Stricture

  • Medical Author: Pamela I. Ellsworth, MD
  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

How are urethral strictures followed after repair?

There is a risk of recurrence of the urethral stricture, and thus follow-up is essential. The physician will ask questions about the force of urine stream, frequency of urination, feeling of complete or incomplete bladder emptying, direction of the urine stream, and other symptoms of urethral strictures. During such follow-up visits, you may be asked to void into a special collection device, uroflow, to measure the speed of urination and the flow of urination. A small ultrasound probe may be placed on the lower part of the abdomen after urination to measure the amount of urine remaining in the bladder (post-void residual). In some cases, a cystoscopy may be performed to look directly at the area of urethra that was repaired.

Urethral strictures in children may result from diaper irritation (meatal stenosis), trauma, prior surgery or instrumentation, or may be congenital. They will often appear with similar symptoms as those in adults.

Meatal stenosis is a narrowing of the opening at the tip of the penis and is felt to occur from diaper irritation in circumcised boys. It may also occur after hypospadias repair. Symptoms include decreased or deflected urine stream. Performing a meatotomy/meatoplasty, crushing the scarred bridge of tissue and cutting it after, is successful in 98%-100% of boys.

For urethral strictures in the penile urethra to the bulbar urethra, dilation is not recommended. DVIU will be successful in approximately 50% of patients. Excision of the stricture if feasible and primary reattachment of the urethral ends is most effective. When this cannot be accomplished, then a patch graft of buccal mucosa is successful.

What is the recovery period after surgery to repair a urethral stricture?

The recovery period after surgery will vary with the procedure performed, duration of catheterization, surgeon preference, and overall health status. A catheter (Foley catheter) is left in the penis after almost all surgeries for treatment of a urethral stricture. How long the catheter remains in place will depend on the procedure performed and surgeon preference. Typically, the catheter is left in place for at least a week. In some cases, a suprapubic tube (tube that goes through the lower abdomen into the bladder) may be left in place to drain the urine in addition to the catheter. With less invasive procedures, the duration may be shorter. The discomfort related to the procedure will also vary with much less discomfort with the less invasive procedures, urethral dilation, and internal urethrotomy. With the more extensive surgery, urethroplasty, a more prolonged course can be expected, varying with the extent of the surgery. Procedures such as dilation and internal urethrotomy are outpatient procedures, whereas more complex repairs may be associated with an overnight stay in the hospital.

Medically Reviewed by a Doctor on 10/29/2016

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