Causes and Diagnoses

Causes and Diagnoses of Urethral Strictures

Causes of urethral strictures include:

  • Perineal trauma (injury to the genitals)
  • Prior urologic procedures performed through the urethra
  • Sexually transmitted diseases
  • Pelvic irradiation for cancer
  • Hypospadias, a birth defect in which the opening of the urethra is not on the tip of the penis
  • Previous surgery for hypospadias
  • Lichen sclerosus (a skin disorder that effects the genitals)

Furthermore, pelvic trauma associated with pelvic fracture can cause a separation of the urethra (pelvic fracture urethral injury or PFUI) just below the bladder and prostate, creating an extensive scar.

Diagnosing a urethral stricture 

Your physician can use a variety of tests to confirm the existence and the severity of a urethral stricture, including:

  • Complex uroflowmetry: This procedure measures the amount of urine in the bladder and the rate at which the urine flows.
  • Cysto-urethroscopy: Also known as cystoscopy, this test is used to examine the inside of the bladder and urethra.
  • Pelvic or urethral ultrasound: This imaging test uses high-frequency sound waves to create an image of the organs.
  • Pelvic multi-resonance imaging (MRI): Using a combination of large magnets, radiofrequencies and a computer, an MRI produces detailed images of organs and structures within the body.
  • Pressure-flow voiding study: This test determines the ability of the bladder and urethra to properly expel urine.
  • Retrograde urethrogram: An X-ray image is taken to study the structure of the urethra and locate the stricture. 
  • Urinalysis: Your urine will be checked under a microscope for the presence of infection or blood.