Urethral Stricture Disease

At Montefiore Einstein Urology, you can access exceptional care for urethral stricture disease. As a global leader in urology, we are an academic-based, national and international referral site for the most complex and high-risk cases. For more than a century, we have been at the forefront of innovation, research and clinical care for genitourinary (GU) conditions.

Ranked in the top 1% of all hospitals in the nation for urology according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of GU conditions. Our multidisciplinary team of world-renowned specialists is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Urology, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety. In addition, we offer patients a full range of support services, from nutritional guidance to rehabilitative therapies. We are leaders in minimally invasive, robotic, and laparoscopic surgical techniques.

When you need urethral stricture disease care, turn to our dedicated multidisciplinary team for a personalized treatment plan.

Urethral stricture disease can develop due to a variety of causes, including trauma, infections, and medical interventions. Blunt or penetrating injuries, such as pelvic fractures or straddle injuries, are common causes of urethral scarring. Medical procedures, such as prolonged catheterization or endoscopic interventions involving the urethra, can also contribute to the condition. Recurrent urinary tract infections and sexually transmitted infections may lead to inflammation and scarring, further narrowing the urethra. Additionally, radiation therapy for prostate cancer or other pelvic conditions, as well as surgeries for benign prostatic hyperplasia (BPH) or prostate cancer, are known risk factors for developing strictures.

The symptoms of urethral stricture disease vary depending on the location and severity of the narrowing. Patients often experience difficulty urinating, a weak or interrupted urine stream, or pain during urination. Frequent urination, a sudden need to urinate, or an inability to fully empty the bladder are also common signs. Recurrent urinary tract infections (UTIs) may occur due to urinary retention, and in some cases, blood may be present in the urine or semen. Severe strictures can lead to complete urinary blockage, which requires immediate medical attention.

Diagnosing urethral stricture disease involves a comprehensive medical evaluation, including a detailed history and physical examination, followed by advanced diagnostic testing. Retrograde urethrography is a key imaging test where contrast dye is used to identify and assess the location and severity of strictures. Cystoscopy, a minimally invasive procedure using a thin, flexible camera, allows direct visualization of the urethra and bladder. Additional tests, such as uroflowmetry, measure the rate of urine flow to detect obstruction, while urodynamic testing evaluates bladder pressure and function during urination. These diagnostic tools provide a clear understanding of the condition, guiding the choice of treatment.

Treatment for urethral stricture disease varies depending on the severity, location of the stricture, and the patient’s overall health. Options include:

• Nonoperative management: temporary catheterization to bypass the stricture and relieve symptoms or urinary retention
• Minimally invasive procedures: urethral dilation, which gradually widens the urethra, and endoscopic urethrotomy, where a cystoscope is used to remove or widen the stricture
• Reconstructive surgery: urethroplasty, a specialized surgical procedure to remove or repair the scarred tissue and reconstruct the urethra, offering a long-term solution for severe cases
• Ongoing monitoring: regular follow-up care to monitor for recurrence and ensure bladder function is optimized