A stricture occurs when a part of the urethra becomes narrowed. Any section of the urethra may be affected. There is usually some scar tissue around the affected part of the urethra that causes the narrowing. The length of strictures vary from less than 1 cm to the full length of the urethra. The diagram below illustrates a fairly long and severe stricture, but many are shorter than this. Urethral stricture is uncommon in men and rare in women.

More pressure is needed from the bladder muscle to pass urine out through a stricture (it acts like a bottleneck). Not all urine in the bladder may be passed when you go to the toilet. Some urine may pool in the bladder. This residual pool of urine is more likely to become infected. This makes you more prone to bladder, prostate and kidney infections. An abscess (ball of infection) above the stricture may also develop. This can cause further damage to the urethra and tissues below the bladder. Cancer of the urethra is a rare complication of a long-standing stricture.

Treatment is usually advised to improve the flow rate of urine, ease symptoms and to prevent possible complications. A specialist surgeon called a urologist advises on treatment. (A urologist treats problems of the urinary tract - such as prostate, bladder, kidney and penis problems.) Treatment options include the following. The one advised by your specialist will depend on factors such as the site and length of your stricture, and also your age and general well-being.

This is usually done by passing a thin plastic rod (boogie) into the urethra. This procedure may be done either under a local or a general anaesthetic. Rods of increasing thickness are gently inserted to gradually widen (dilate) the narrowed stricture. The aim is to stretch and widen the stricture without causing additional scarring. However, a stricture often tends gradually to narrow again after each dilation. Therefore, a repeat dilation is commonly needed every so often when symptoms recur. (Some people are given a self-lubricating catheter which they insert themselves regularly to keep a stricture dilated.)

As a rule, the shorter the stricture, the greater the chance of a cure with dilation. It is a relatively easy procedure to do and so may be tried first.

In this procedure, a thin telescope is passed into the urethra to see exactly where the stricture is. This is done during a general anaesthetic. A tiny knife is then passed down the telescope to cut along the stricture. This widens the narrowed stricture. You will get some relief of symptoms from this procedure. About one case in three is cured for good. However, like dilation, the stricture may re-form and the procedure may have to be repeated from time to time in some cases.

A corrective operation may be an option if the above do not work. Various techniques are used. For example, a short stricture can be cut out and the two ends of the healthy urethra stitched together.

If the stricture is longer, then one kind of operation is similar to skin grafting the inside lining of the urethra. A graft is usually used from the inside of your cheek to form the new section of your urethra. Techniques continue to improve and your specialist will advise if an operation is likely to be successful, and which operation is best for the length and site of your stricture. As a rule, there is a high success rate in curing symptoms with these operations.

People who are unfit for surgery, due to age or other infirmity, may be offered a stent. This is a spring-like device which holds the walls of the urethra open and prevents the stricture from blocking the flow of urine. It is used as a last resort, as the device sometimes dislodges and can cause pain during intercourse.

A long course of antibiotics may be advised to prevent urine infections until a stricture has been widened.