Urethral stricture requires treatment by specially trained urologist
Recurring urinary tract infections in men could signal a more serious issue.
By Casandra Andrews
candrews@health.southalabama.edu
Men who have been treated for prostate cancer or who have suffered a straddle injury can develop urethral stricture, a progressive narrowing of the tube that carries urine from the bladder to the outside of the body. While it’s a rare condition – affecting only about 500 out of 100,000 people – urethral stricture is more common in men, especially those who are older.
“They may have difficulty with urination or feel that they are not emptying their bladder well,” said Jatinder Kumar, M.B.B.S., M.S., M.Ch., M.D., a fellowship-trained reconstructive urologist at USA Health University Urology. “Many times, the common presentation is a recurrent urinary tract infection.”
Seeing a urologist for these symptoms is key, Kumar said, to confirm the diagnosis and rule out other causes, such as an enlarged prostate. If urethral stricture is confirmed, the patient may need urethroplasty, a surgery to reconstruct the urethra to allow urine to flow properly.
“A urethroplasty is an open operation in which we reconstruct the tube using skin taken from inside the mouth, and it has a success rate of up to 95%,” Kumar said. It’s also usually covered by health insurance.
While the procedure is not new, urethroplasty is ideally performed by a urologist with advanced training in reconstructive urology. Kumar, the only reconstructive urologist on the upper Gulf Coast, completed a fellowship in advanced urology/reconstructive urology at the University of Florida in Jacksonville prior to joining USA Health.
Kumar said the surgery is tailored to each patient depending on the length of the stricture, the exact location, the age of the patient and their overall health. Depending on those factors, the procedure can be performed in an outpatient or inpatient setting, with the patient spending no more than one night in the hospital. Overall recovery is one to three weeks, he said.
The most common alternative to urethroplasty – using an endoscopic technique to dilate or cut the urethra – is far less likely to be successful and may even worsen the scar tissue that caused the stricture. “A small stricture could end up becoming much more complex and difficult to fix,” Kumar said. “If you have already had a dilation procedure, and it did not help, then urethroplasty would be a more definitive repair.”
