Urinary strictures, also known as urethral strictures, are narrowing of the urethra due to scar tissue or inflammation, leading to difficulties in urination. They can occur in both men and women, but are more common in men. Urinary strictures can result from various causes including infections, trauma, previous surgeries, or inflammatory conditions like urethritis.

Causes:

1. Trauma: Injuries to the pelvic region or the urethra itself can lead to scarring and subsequent narrowing of the urethra.

2. Infections: Sexually transmitted infections (STIs) such as gonorrhea or chlamydia can cause inflammation and scarring of the urethra, leading to strictures.

3. Surgery: Previous surgeries involving the urethra or nearby structures can sometimes result in scarring and narrowing of the urethral passage.

4. Radiation therapy: Radiation treatment for conditions such as prostate cancer can cause damage to surrounding tissues, leading to strictures.

5. Inflammatory conditions: Conditions like urethritis (inflammation of the urethra) or certain autoimmune disorders can cause inflammation and scarring of the urethra.

Symptoms:

1. Difficulty urinating: Narrowing of the urethra can make it difficult to start urination, maintain a steady stream, or completely empty the bladder.

2. Weak urine stream: A reduced flow of urine may be noticed, often accompanied by straining during urination.

3. Frequent urination: Patients may feel the urge to urinate more frequently due to incomplete emptying of the bladder.

4. Pain or burning: Pain or a burning sensation during urination may be experienced, especially if there is inflammation present.

5. Urinary retention: In severe cases, urinary strictures can lead to urinary retention, where the bladder is unable to empty completely.

Diagnosis:

1. Medical history and physical examination: Your doctor will ask about your symptoms and medical history, and perform a physical examination.

2. Uroflowmetry: This test measures the flow rate and volume of urine during urination.

3. Cystoscopy: A thin, flexible tube with a camera (cystoscope) is inserted into the urethra to visually inspect the urinary tract.

4. Imaging tests: Imaging studies such as ultrasound, CT scan, or MRI may be done to evaluate the structure of the urinary tract.

5. Urethral pressure profile: This test measures the pressure within the urethra during urination.

Treatment:

1. Dilation: A procedure called urethral dilation involves gradually stretching the urethra using progressively larger dilators to widen the narrowed area.

2. Urethrotomy: In this procedure, the stricture is cut or incised using a surgical instrument inserted through the urethra.

3. Urethroplasty: For more severe or complex strictures, surgical reconstruction of the urethra (urethroplasty) may be necessary.

4. Medication: In some cases, medications such as alpha-blockers or steroids may be prescribed to help reduce inflammation and improve urinary flow.

5. Self-catheterization: Some patients may need to perform intermittent self-catheterization to help empty the bladder if strictures are causing urinary retention.

It’s important to seek medical attention if you experience symptoms of urinary strictures, as untreated strictures can lead to complications such as urinary tract infections, bladder stones, or kidney damage. Your doctor can recommend the most appropriate treatment based on the cause and severity of your condition.