Strictures are narrowings or scarrings of the urethra associated with abnormal, unhealthy tissue. Typically they are caused by trauma due to straddle injuries, passage of stones, or frequent catheterization or cystoscopic exploration.
Patients who have urethral strictures often develop symptoms of obstructive voiding or urinary tract infections such as prostatitis or epididymitis. Some patients ultimately develop urinary retention.
Management of urethral stricture disease is determined by the location, length, and, usually, the pathologic cause (trauma versus infection). Urethral dilatation is the oldest and simplest treatment for urethral stricture disease. Internal urethrotomy is a procedure that opens the stricture by incising or ablating it transurethrally. It has now been demonstrated that the most dependable technique of anterior urethral reconstruction is the complete excision of the area of fibrosis.