Urethral Stricture: Causes, Facts, Symptoms, Diagnosis, Treatment, Exercises, Prognosis, Do’s & Don’ts

Urethral Stricture is a pathological condition mostly found in males which occurs in the urethra, which is a tube which carries urine from the bladder so that it can be eliminated from the body. In normal males, the width of the urethra is enough for urine to pass through it easily, but in cases of Urethral Stricture there is narrowing of this tube resulting in difficulty for the urine to pass through it. This condition is called as Urethral Stricture. This condition causes flow of urine to be severely restricted.

The narrowing of the urethra is termed as Urethral Stricture. This is basically caused by inflammation or due to development of a scar tissue. There are various reasons for development of scar tissue in the urethra, but basically it develops in people who have had surgery for penile implants and are more at risk for developing this condition. According to a study, a straddle injury can cause Urethral Stricture. A straddle injury is caused due to being hit around the scrotum or falling directly on bicycle bar. Some of the other causes for Urethral Stricture are pelvic fractures, insertion of catheters, radiation therapy, or prostate surgery. In rare cases a Urethral Stricture can be formed due to presence of a tumor near the urethra.

Some common facts about Urethral Strictures are:

• This disease tends to occur more in males than in females.
• This disease is mainly caused due to inflammation of urethra as a result of some sort of injury, direct trauma, any surgical procedure, or some sort of infection.
• At times, Urethral Strictures remain asymptomatic and at other times cause severe urinary retention.
• In order to diagnose Urethral Strictures the best methods are imaging studies and endoscopy.
• The best way to treat Urethral Strictures is by doing surgery to widen the urethra and allowing the urine to pass through easily.
• The prognosis for this disease is pretty good in all cases.

There can be numerous symptoms caused by Urethral Strictures, which can be minimal to severe. Some of the symptoms are:

• Reduced volume of urine output
• Increased urinary frequency and urgency
• Painful urination
• Urinary incontinence
• Abdominal or pelvic pan
• Urethral discharge
• Swelling in the penile region
• Hematuria
• Dark colored urine.

To diagnose Urethral Stricture, the treating physician will perform the following:

• Reviewing Medical History And Symptom Profile: To begin with, the treating physician will take a detailed history and inquire about the symptoms experienced by the individual. This will help determine if there are any risk factors for Urethral Stricture. 
• Physical Examination: The next step will be to perform a detailed physical examination. The physician will examine the penile region in order to look for any signs of a Urethral Stricture. This can be identified by visible swelling in the area. 
• Testing: The next step will be to confirm the diagnosis of Urethral Stricture by conducting the following tests:
• Measuring the rate at which the urine flows
• Conducting a urinalysis to look for presence of any bacteria
• Cystoscopy: This procedure is done to look at the internal structures of the bladder to identify any obstruction in the bladder or the urethra
• Looking at the size of urethral opening.

These above tests will confirm the presence of a Urethral Stricture.

The best approach for treatment of Urethral Stricture is to widen the urethra so that the urine may flow easily. This is done by an instrument called as dilator. In this procedure, the physician will insert a small wire through the urethra and into the bladder. Gradually larger dilators will be inserted to make the urethra wide enough for urine to pass through easily.

Another option for treatment of Urethral Stricture is surgery. The name of the surgical procedure is urethroplasty and it is done for severe cases of Urethral Stricture. In this procedure, the affected tissue is removed and the urethra is reconstructed.

If the above two approaches do not relieve the stricture, then the physician will resort to diverting the flow of urine to a catheter inserted in the abdomen. This procedure is extremely rare and is done only as a last option.

To do this exercise, sit on the floor in kneel down position with your buttock rested on the soles of your feet. Keep your back straight with your hands on the knees. Try to keep your knees as close to each other as possible. Slowly take a deep breath, hold for few seconds and exhale. Try to sit in this position for as long as you can preferably for at least 10-20 mins each time. Try repeating this at least 2-3 times a day and continuing doing it every day for few weeks to start seeing its benefits. Diamond pose exercise can be quite effective for problems related to urinary system, digestive system and weakness of leg muscles. This exercise can especially be helpful for problems related to Urethral Stricture. You can do this exercise either before having your meals or after having your meals.

This exercise is a slight variant of the Diamond pose and gives similar benefits. Sit in the same kneeling down position as in Diamond pose or Vajrasana, and slowly raise your hand above your head and bend down until your forehead touches the ground and hands extended while resting on ground. You will derive similar benefits as of Diamond Pose but this exercise also stretches your spine, helps tone your abdomen, and stretches your shoulder muscles.

This exercise is again similar to Ardha Kurmasana, but in this exercise you have to make a fist of both your hands and then press the navel gently with the tip of your thumb and bend your head down as much as possible while exhaling, stay in this position for few seconds and then bring your head back to the original position while inhaling. In addition to getting the benefits of Diamond pose exercise, this is also helpful for problems related to digestive system and reproductive system in women.

Usually, the overall prognosis of Urethral Stricture is pretty good and majority of individuals lead a normal life post treatment. In some instances, there can be urinary retention due to the stricture which is a potentially serious condition which requires emergent medial attention.

Generally speaking, Urethral Stricture cannot be prevented as this disease develops as a result of an injury or a direct trauma to the region or as a result of some surgical procedures. Since it is difficult to avoid such instances hence Urethral Strictures cannot be totally prevented; however, some of the rare causes of this disease, which are transmitted due to bad sexual practices can be prevented by practicing safe sex.

Some of the do’s and don’ts for Urethral Strictures are as mentioned below:

• One needs to abstain from alcohol as much as possible
• One needs to stay away from foods rich in acidic content
• Caffeine should be avoided.
• One needs to avoid antihistamines medications like Benadryl etc:
• One needs to avoid sedative medications such as those given for insomnia and anxiety.
• Avoid narcotic medications as much as possible.
• It is important to go to the bathroom as soon as an urge is felt.
• It is recommended to urinate every couple of hours and maintain consistency.
• Make sure that the bladder is completely devoid of urine after every passage of urine.
• It is useful to take time to free up the bladder.
• Diligent follow ups and taking medications as directed is also imperative.