Urethral Stricture: Advanced Reconstructive Urology for Urinary Health

Written by: Editorial Team

Medically reviewed by: Dr. Abhik Debnath - Consultant Urologist, Andrologist & Kidney Transplant Surgeon

Urethral Stricture Disease is are common yet overlooked urological condition where the urethra (urine passage) becomes narrowed due to scarring or injury, causing difficulty in urination, pain, and recurrent infections. The condition can significantly impact a patient’s daily life, leading to discomfort, anxiety, and, if untreated, even kidney problems.

At PACE Hospitals, Hyderabad, our team of reconstructive urologists offers the latest surgical and minimally invasive treatments for urethral strictures. With a focus on restoring normal urinary function, reducing recurrence, and improving overall quality of life, PACE Hospitals is recognized as a leading center for urethral stricture treatment in South India.

A urethral stricture is a narrowing caused by scar tissue formation anywhere along the urethra, from the bladder outlet to the tip of the penis. This narrowing restricts or slows the urine flow, causing symptoms like:

• Weak or slow urinary stream
• Painful urination
• Dribbling or incomplete emptying
• Recurrent urinary tract infections
• Blood in urine or semen
• Painful ejaculation or pelvic discomfort

Strictures are far more common in men due to the longer urethral anatomy and are rare in women and children.

Although the exact cause isn't always clear, urethral stricture most frequent triggers include:

• Trauma to the pelvis or perineum (e.g., road accidents, fractures)
• Previous catheterization or medical instrumentation
• Urinary tract infections, especially sexually transmitted infections like gonorrhea or chlamydia
• Radiation therapy for prostate or pelvic cancer
• Scarring from prior surgeries (e.g., prostate, hypospadias repair)
• Chronic inflammation or repeated infections

Men who have undergone prostate cancer treatments or urinary tract surgeries face an increased risk of developing a urethral stricture.

Symptoms often worsen slowly as the narrowing gets worse:

• Reduced or weak urine stream
• Straining while urinating
• Feeling of incomplete bladder emptying
• Pain or burning sensation
• Dribbling or split urine stream
• Blood in urine or semen
• Recurrent urinary tract infections
• Swelling of the penis or lower abdomen
• Inability to pass urine (acute urinary retention) in severe cases

If left untreated, strictures can cause bladder damage, infections, stones, and even kidney failure.

Accurate and timely diagnosis is essential for effective management of urethral stricture disease. At PACE Hospitals, we use a combination of advanced diagnostic techniques, which includes the following:

1. Uroflowmetry

A non-invasive test that evaluates the urine flow rate and pattern to detect possible obstruction.

2. Retrograde Urethrogram (RUG)

RUG is a X-ray imaging studies used to examine the urethra, the tube that carries urine outside of the body.

3. Urethroscopy / Cystoscopy

Direct visual examination using a fine scope to evaluate the inner urethra.

4.  Ultrasound or MRI Urethrogram

Provides detailed imaging of the urethral anatomy and surrounding tissues.

5. Urine Tests & Culture

Detects urinary infections or inflammation that may contribute to the stricture.

Treatment choices for urethral stricture disease may ranges from less invasive, temporary solutions to definitive surgical reconstruction. The best choice depends on the stricture's location, length, and severity.

Common treatments include:

A small internal incision is made using a cold knife or Holmium laser to widen the stricture.

• Suitable for short strictures (<1 cm).
• Outpatient procedure; minimal pain.
• Recurrence possible; repeat treatment may be required.

PACE Hospitals uses Holmium laser urethrotomy for high precision, minimal bleeding, and faster recovery.

This is the gold standard for definitive treatment, especially for long or recurrent strictures.

Performed by reconstructive urologists at PACE, this involves:

• Removing the scarred section (excision and primary anastomosis), or
• Reconstructing the urethra using buccal mucosa grafts (tissue from the inner cheek).

Types of Urethroplasty:

• End-to-end anastomotic urethroplasty: For short bulbar strictures.
• Substitution urethroplasty: Uses grafts for long or complex strictures.
• Staged urethroplasty: For patients with severe fibrosis or prior failed surgeries.

Success rate: Approximately 85–90% at 5 years (significantly higher than endoscopic options).

Recovery:  Catheter for 2–3 weeks, return to normal activities in 3–4 weeks.

PACE Hospitals provides transparent, affordable, and patient-friendly pricing for all reconstructive urology procedures.

PACE Hospitals is a pioneer in reconstructive urology in Hyderabad, providing advanced treatment for complex disorder of urethral, bladder, and genital.

Key highlights:

• Expert Urologists: Our team comprises highly skilled reconstructive surgeons with advanced expertise in microsurgical and graft-based urethral reconstruction.

• Advanced Laser Technology: Holmium Laser system are used to perform precision urethrotomy with minimal tissue stress and speedier recovery.

• Comprehensive diagnostics: Includes Retrograde urethrogram (RUG), magnetic resonance imaging urethrogram, and 3D imaging for individualised planning.

• Post-surgical Rehabilitation: Includes uroflowmetry tracking and bladder training for sustained recovery.

PACE’s reconstructive urology outcomes have been among the best in India, with a >85% long-term success rate and improvement in patients' quality of life.

While not all strictures are preventable, you can reduce risk by following these measures:

• Avoid pelvic injuries and use seat belts.
• Treat urinary infections promptly.
• Practice safe sex to prevent sexually transmitted diseases.
• Avoid unnecessary or prolonged catheter use.
• Stay hydrated and maintain regular urination habits.
• Avoid self-catheterization unless instructed by a doctor.

With timely diagnosis and proper surgical management, most patients recover completely.

After successful urethroplasty at PACE Hospitals:

• Urine flow improves greatly.
• Recurrent infections subside.
• Pain and strain subside.
• The quality of life, confidence, and sexual function improve dramatically.