Treatments of Urethral Stricture
Traditionally, urethral strictures were treated by dilating (enlarging) the urethra with a balloon or an incision. However, most patients had only temporary relief from this treatment. The stricture would typically recur within weeks to months. In addition, these treatment options could cause further injury to the scarred urethra, leading to worsening of the condition.
Today, surgeons focus on complete removal of the scar tissue. Although the stricture may still recur following this surgery, recurrence rates are low, and overall patient satisfaction is excellent.
Surgical Correction of Urethral Stricture
Strictures that are located closer to the bladder can almost always be treated by removing the scar and reconnecting the urethra.
For those located closer to the tip of the penis or for those that are fairly long, other tissue needs to be used to form a new urethra of sufficient diameter. These tissues can either be taken from penile skin or from the inside of the cheek. The latter has shown to have a higher success rate in forming part or all of the new urethra, and tends to be well tolerated.
Most operations are outpatient. An overnight stay is rarely needed. The incisions are usually small, and most patients report little pain afterwards. The most bothersome aspect to patients is often the catheter. However, catheter use is necessary while the urethra is healing. Catheters are usually removed after two to three weeks.
In experienced centers, stricture surgery has a long-term success rate of more than 95 percent. For the small subset of repairs that are very complex, for example those involving long segments of the urethra, the success rate is about 85 percent to 90 percent.