The urethra is a tube that transports urine from the bladder to the tip of the penis (or perineum in the female). It can become narrowed or blocked due to a scarring process – a condition known as urethral stricture.
Scarring (strictures) are most commonly due to previous trauma, infection or inflammatory processes such as lichen sclerosus, or as a longer-term complication of surgery to correct congenital anomalies of the urethra (hypospadias).
Symptoms of urethral strictures can be poor urinary flow, difficulty emptying the bladder, urinary tract infection (UTI), urinary storage symptoms such as frequency or urgency, and ultimately they can obstruct the urethra completely and cause acute retention of urine (blockage).
The initial investigation for the above symptoms is usually a telescopic inspection of the urethra and bladder, known as a cystoscopy. This can be done very quickly and easily under a local anesthetic, but may not be able to see beyond the narrowing.
The further investigation to delineate the problem is an X-ray called an urethrogram. This is done by instilling some x-ray contrast (dye) into the tip of the urethra, and this will provide more accurate information as to the length, location and caliber of the stricture. With this information, the best decision about treatment can be made.