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A urethral stricture is a narrowing of the urethra that may cause painful urination and the inability to empty the bladder. Some of the causes of a urethral stricture include scarring, trauma (such as falling on a bike frame), infection, procedures involving the urethra (cathetors, surgery, or cytoscopy), congential abnormalities, or even an enlarged prostate due to BPH.
In about a third of the cases, doctors can find no specific cause for this condition. Sometimes it is caused by a tumor growing near the area, but this is very rare. When men are diagnosed, there is often a urinary tract infection present. Urethral stricture can be a lifelong condition and it can be associated with prostatitis.
There appears to be a slightly higher incidence of prostatitis among urethral stricture patients. This connection may be due to the way the stricture causes fluid to travel. Normally, fluid travels from the prostate to the urethra when a man ejaculates. But patients with a urethral stricture have issues with urinating. This high-pressure voiding can cause urine to backflow into the prostate ducts, causing inflammation or an infection.
How Is a Urethral Stricture Diagnosed?
A urologist is the type of doctor most likely to diagnose urethral stricture by cytoscopy. Cytoscopy involves inserting a flexible scope into the urethra and bladder. A noninvasive method to diagnose a urethral stricture is ultrasound, which can be done along the length of the penis without going through the urethra. Other tests your doctor may use to diagnose a urethral stricture include post-void residual volume, a retrograde urethrogram, urinalysis, tests for Chlamydia or gonorrhea, urinary flow rate, or urine culture.
Symptoms of urethral stricture include:
- Blood in semen
- Dark or bloody urine
- Difficulty urinating or inability to urinate
- Lower urine output
- Painful urination
- Slow urine stream
- Pelvic pain
- Pain in lower abdomen
- Penis swelling
- Spraying of urine
If the stricture completely blocks the urine flow, this is an emergency and needs immediate treatment.
Treatments for Urethral Stricture
There are several conventional ways to treat a urethral stricture. No drug treatments are available for this condition except to treat the pain. Most of the conventional treatments are surgical. The doctor may widen the urethra with urethral dilatation by inserting a thin instrument in the urethra to stretch it. This is done under local or general anesthesia. The doctor insets rods of increasing diameters into the urethra to open up the narrow part. Keep in mind that it is common for problems to recur and for treatment to be repeated.
If urethral dilatation does not work, the doctor may suggest other invasive surgeries, which may include urethrostomy, urethral stent placement, and open urethral reconstruction. Look for a doctor who is trained in male urethral and penile reconstructive surgery if you want to explore more invasive procedures. Because scar tissue can cause the symptoms to come back, patients can become very frustrated with this condition.
Men who are looking for more natural ways to help their urethral stricture, or who have had little success from conventional treatments, may find some relief in bee pollen. Bee pollen is an affordable approach that has been found to support urinary health and may relax the muscles in the lining of the urinary tract. Some patients report having good results with homeopathic remedies for their long-term urethral strictures. This type of natural treatment would require guidance by a homeopath.