Urethral stricture

Background

Urethral anatomy.

• Occurs relatively commonly in men
• Most common etiology is idiopathic in well-resourced countries, traumatic in resource-poor regions
• Other common etiologies include instrumentation, infection, and inflammatory skin conditions

Clinical Features

• Chronic obstructive voiding symptoms
• Sexual dysfunction

Complications

• Acute urinary retention
• Urolithiasis
• Urinary tract infection
• Urethral fistula
• Periurethral abscess

Differential Diagnosis

• Benign prostatic hyperplasia

Evaluation

Diagnosis

• Should undergo cystourethroscopy, retrograde urethrogram, voiding cystourethrogram, and/or ultrasound urethrography
• Noninvasive studies cannot definitively diagnose

Management

• Treat resulting complications
• No absolute contraindication for treatment of urethral strictures
  • Options for treatment include minimally invasive therapies, urinary diversion procedures, and surgical reconstruction (eg, urethroplasty)
• Consult urology