Is your urine stream weaker than it used to be? Maybe you have to strain to pee, or you still feel like your bladder is full afterward. Scar tissue in your urethra could be the reason.
Your urethra is the tube that carries urine out of your body. When scar tissue makes part of it too narrow, doctors call it a urethral stricture. Urethral stricture treatment can make it easier to pee, but the best option depends on where the narrowing is, how long and tight it is, and whether you’ve had treatment before.
How Does Your Urologist Check for a Urethral Stricture?
Your urologist will ask about your symptoms, past injuries, infections, and procedures. Tests may include:
- A urine test to check for infection or blood
- A urine flow test to see how fast you pee
- A bladder scan to see how much urine remains after you pee
- Cystoscopy, which uses a tiny camera to look inside your urethra
- A special X-ray that shows where the urethra is narrow and how long the stricture is
What Are Your Urethral Stricture Treatment Options?
Some treatments stretch or cut the scar tissue to improve urine flow. Others repair the urethra. Your urologist will explain which approach makes sense for your stricture.
Urethral Dilation
During dilation, your urologist gently widens the narrowed area with small tools or a balloon. It may work for certain short strictures, especially if you haven’t had treatment before.
But dilation doesn’t remove the scar tissue. The narrowing can return, and repeated dilation may not give lasting relief.
Direct Visual Internal Urethrotomy (DVIU)
For DVIU, your urologist passes a small scope through the urethra and makes a cut in the scar tissue to widen the opening. Like dilation, it tends to work best for certain short strictures that haven’t been treated before. The stricture can come back.
Drug-Coated Balloon Treatment
If a stricture returns, a drug-coated balloon may be an option for some people. The balloon opens the narrowed area and releases a medicine called paclitaxel to reduce new scar tissue. Doctors may use this treatment for certain short, recurring strictures in men. It’s not an option for every type of stricture.
Urethroplasty
Urethroplasty is surgery to repair or rebuild the urethra. For some short strictures, the surgeon can remove the scarred section and reconnect the healthy ends. For longer ones, the surgeon may use a small piece of tissue from inside your cheek to widen the urethra.
Your urologist may recommend this surgery if the stricture is long, has a lot of scar tissue, or keeps coming back. Urethroplasty often offers a better chance of lasting relief than repeating dilation or DVIU.
You’ll usually have a catheter for a few weeks while the area heals.
What if You Can’t Pee at All?
A severe stricture can block urine completely. If you can’t pee, seek emergency care. Your bladder needs to be drained right away. A doctor may place a catheter through the urethra or through a small opening in your lower belly.
Find the Right Urethral Stricture Treatment
You shouldn’t have to keep struggling with a weak stream or trouble emptying your bladder. The right treatment depends on your stricture and your goals.
If you’re in Eugene or Springfield, Oregon Urology Institute can help you understand your choices. Call 541.334.3350 to schedule an appointment.