Urethral Stricture: Symptoms, Causes, Treatment

Urethral stricture (thesaurus synonyms: bulbar urethral stricture; bulbar urethral stenosis; bulbar urethral stricture; bulbar urethra stricture; bulbar urethral stenosis; bulbar urethral stricture; distal meatus stricture; distal meatus stenosis; distal urethral stenosis; urethral orifice stricture; Urethral stenosis; urethral stricture; urethral stricture after birth; urethral stricture after injury; urethral stenosis; infectious urethral stenosis; infectious urethral stricture; infectious urethral stricture a. n.k. ; meatus stenosis; meatus stricture; posttraumatic urethral stricture; posttraumatic urethral stricture; spastic urethral stricture; spastic urethral stricture; sphincteric spasm of the urethra; stenosis urethrae; stricture of the posterior urethra; stricture of the posterior urethra; stricture of the anterior urethra; stricture of the anterior urethra; stricture of the meatus urinarius; traumatic urethral stenosis; traumatic urethral stricture; traumatic urethral stenosis; traumatic urethral stricture; urethral stenosis; urethral contracture; urethral stenosis; urethral stricture; urethral obstruction; urethral stenosis; urethral stricture after birth; urethral stricture after injury; urethral stenosis; urethral obstruction; ICD-10-GM N35. -: Urethral stricture) refers to a narrowing of the urethra. This usually leads to obstructive micturition disorders (impeding urine flow), which cause consequences for the entire urinary tract. Urethral stricture can be congenital (congenital; very rare) or acquired. One can distinguish the following forms of urethral stricture according to the ICD-10-GM:

  • Posttraumatic urethral stricture (ICD-10-GM N35.0) – narrowing of the urethra caused by injury.
  • Postinfectious urethral stricture (ICD-10-GM N35.1) – narrowing of the urethra that occurs after an infection of the urethra
  • Other urethral stricture (ICD-10-GM N35.8).
  • Urethral stricture, unspecified (ICD-10-GM N35.9)

According to the location, urethral stricture can be classified as follows:

  • Bulbar urethral stricture (between the sphincter and the beginning of the mobile penis; portion of the urethra fixed to the pelvic floor) – the most common form of urethral stricture with circa 50%.
  • Penile urethral stricture (in the mobile part of the penis) – circa 30% of cases.
  • Urethral stricture in the area of the fossa navicularis (ampullary dilation of the male urethra (urethra), located in the area of the glans penis just before the meatus urethrae externus (external urethral orifice); urethral segment in the area of the glans) – circa 20% of cases.
  • Urethral stricture in the area of the posterior urethra (“posterior urethra” = course through the prostate/prostatic urethra and the pelvic floor muscles/membranous urethra) – very rare; it occurs in the context of injuries (e.g. traumatic urethral tear) or after a radiatio (radiation therapy) in the context of a prostate carcinoma (prostate cancer).

Sex ratio: men are affected significantly more often than women (due to the much longer urethra (urethra)). Frequency peak: The disease can occur at any age. In patients under 45 years of age, the cause is often trauma (injury) or the condition following hypospadias surgery (surgery for congenital malformation of the urethra). In those over 45 years of age, the cause is usually transurethral surgery (surgical procedures through the urethra). The prevalence (disease incidence) for men is approximately 0.9% (in industrialized countries). Course and prognosis: The disease leads to micturition difficulties (discomfort during urination) and can ultimately lead to a loss of kidney function.Bulbar urethral stricture – the most common form of urethral stricture at approximately 50% – has the most favorable prognosis. Urethral stricture is often recurrent. The more extensive the stricture, the more distal (Latin distare = to move away; “further from the center of the body” or “distant”) it is located, and the more frequently it has been treated, the greater the risk of recurrence. With the procedure “urethrotomia interna” (means of choice; first therapeutic attempt of short-stretch urethral strictures without pronounced fibrotic reaction), the recurrence rate is 50-60%.