Tightness of the urethra – causes, symptoms and therapy

Tightness of the urethra or urethral stricture most commonly makes itself felt by the following symptoms:

Caused by the thightness of the urethra it comes to a weak urinary stream. Furthermore painful urination as well as the tendency to recurring urinary tract infections are also characteristic. Early recognition and initiation of consistent treatment are important to avoid the disease leading into a kidney damage.


Your experience is needed!

On our website we would like to inform you as comprehensively and objectively as possible about the different therapy options for the treatment of urethral stricture.

We are therefore looking for patients who have undergone the following treatments:

  • one or more internal urethrotomies
  • one or more urethral dilations (bougienages)
  • buccal mucosa urethroplasty
  • surgical treatment with MukoCell®
  • end-to-end anastomosis

We are particularly interested in possible side effects that may occur. All information supplied will be treated as strictly confidential, if requested.
Please send us a message to service@urethralstricture-therapy.com

Overview of Treatment Options:

Depending on the location of the stricture and the risk of recurrence one of the following therapy options can be selected to ensure optimum patient treatment.

Urethral reconstruction with oral mucosa cells (MukoCell®)

A constricted and scarred urethral needs tissue replacement to ensure a sufficient urine flow. The tissue replacement is normally taken from the oral mucosa.

Meanwhile, the urethral reconstruction can be executed with cell transplant cultivated in the laboratory. The transplant can be bred from the patient’s own oral mucosa cells. The cell production needs three weeks, afterwards it can be used to rebuilt the patient´s urethral.

Advantages (+):

  • excellent recovery chances
  • gentle and modern treatment processes
  • no extraction of oral mucosa
  • officially approved medicinal product for an advanced therapy (MukoCell®)

Disadvantages (-):

  • so far available in a limited number of clinics only
More Information

Urethra reconstruction with oral mucosa

Traditionally, the required tissue replacement for a constricted and scarred urethra is taken from the oral cavity. Depending on the length of the stricture, a piece of the oral mucosa in a suitable size is removed whether from the lower lip or cheek and is sewn to the urethra to gain a sufficient urethra opening.


Advantages (+):

  • excellent chances of recovery

Disadvantages (-):

  • extensive extraction of oral mucosa
  • sometimes scarrings in the oral cavity
  • can limit the lower lip mobility
  • can cause a feeling numbness in the mouth, cheek and lips area
  • can lead to facial expression and problems with speaking and drinking
  • can increase the salivation
  • extended operation time due to two surgical interventions (urethra and mouth)
  • risk of injuring the salivary gland entrance
  • at a recurrence, a lack of sufficient oral mucosa is possible or oral mucosa has to be again extracted from the injured area
  • the procedure isn´t confirmed by independent, prospective studies
  • many doctors haven´t verifiable knowledge concerning oral area operations, urologists are not trained on it
More Information

Urethra bougienage
Urethra expansion

Picture source: Urethra dilatation-Source Wikipedia.de

The advantage of the urethra bougienage respectively the urethra expansion is, that this therapeutic option can be ambulatorily and mostly without anaesthesia executed. But the therapy can only eliminate the symptoms of the disease for a short term. The surgeries have to be repeated constantly, leading to new injuries with scarrings and a general worsening of the disease.

Advantages (+):

  • ambulatory treatment without anaesthesia

Disadvantages (-):

  • very high recurrence and complication rate
  • regular repetition of the surgery is needed
  • surgery repetitions worsen the disease and lead to extensive strictures
  • long-term chances of recovery decline with every single surgery
More Information


Picture source: urethrotomy source urology-texbook.com

Condition for this intervention is as a rule a first-time appearance of the urethra narrowness as well as an affected (touched) area which should have maximum one expansion of 1.5 centimetres.


Advantages (+):

  • an easy intervention
  • with first-time appearance of the illness the intervention is indicated

Disadvantages (-):

  • relapse – probability with 70% – 100%
  • every cut in the scarred urethra leads to a new scar with a renewed narrowing by which at the same time the cicatrisation becomes bigger and longer,
  • the creation of a tube / opening for the urination becomes more and more difficult with scarred fabric
  • the clinical picture gets worse with every further intervention
  • repeated urethrotomy can lead to irreparable damages of the urethra
More Information
Urethral stricture

Urethral stricture – as the name already promises, this is an unpleasant, yet frequently occurring medical condition. After all, one percent of all men suffer from a urethral stricture, women are a lot less affected. This is established within the structure of the genital tract: women are basically more protected from a stricture, due to a shorter urethra. If you detected symptoms of a urethral structure, you should contact an urologist immediately. Although many men have difficulties in doing so, it is necessary to treat a urethral stricture as quickly as possible.

Injuries as a cause for urethral stricture

It can be deduced from statistics, that injuries are causative for a urethral stricture in the majority of cases. Already very small injuries can lead to scarring, which in turn leads to a stricture. Those microscopically small injuries can happen in consequence of a bladder examination, for instance, or they can emerge during positioning a urinary catheter.


The treatment at a urethral stricture

Since the causes of urethral stricture are individually, there can also be no general treatment plan. Instead, an individually tailored treatment plan needs to be created in any case according to precise investigations. In its planning, the following factors play a crucial role: the length and position of striction, amount of moderate urine, existing urinary tract infections (UTIs) and the involvement of the kidneys. In most cases, therapeutic measures include an invasive and not very easy operation in case of a urethral stricture. These are carried out as a rule in specialized clinics, in order to avoid complications. Depending on the shape of the urethral narrowing a matching surgical technique…


What happens during a urethral stricture?

The first sign for a urethral stricture is a clearly diminished stream of urine. This change in the urine stream is also the clearest sign for this disease. The stream doesn’t just have to be weaker, but it can also appear different in form and / or direction. A different form means that the urine does not necessarily flow in one stream, but rather widespread. Sometimes, the affected person has to press for urine to flow. It can also be the case that the urine stream is delayed since the urine first needs to pass the stricture of the urethra. Another complication of urethral strictures is residual urine in the…


Scar formations as a consecutive complication

Another unpleasant complication of urethral strictures is the formation of scars on parts of the cavernous body of the penis, the so called corpus spongiosum. If this remains untreated for a longer period, it can lead to complete scarring of the cavernous body which is called spongiofibrosis and entails erectile dysfunction of the penis. This implies that quick action is required and it is important not to wait too long until seeking medical attention. The doctor can minimize the risk of complications for the patient with the appropriate treatment.


Medical examinations and diagnosis of urethral strictures

The urologist is the medical specialist for all diseases of the urinary tract. The urologist should be consulted as soon as any changes become noticeable. When patients report changes in the flow of urine or frequent infections of the urinary tract, the urologist will investigate the presence of a urethral stricture. In many cases however, urethral strictures remain inconspicuous until the onset of acute urinary retention. Until the underlying causes become more specific, the urologist will focus on creating an anamnesis. This involves documenting the patient’s entire medical history and recording detailed descriptions of the physical complaints. Typical questions asked for the anamnesis include the following:   Have diseases of…


Congenital malformation as a cause of urethral strictures

In five to ten percent of cases, congenital malformations of the urethra constitute the underlying cause of urethral strictures. Physicians distinguish between different types of malformation and the specific procedures involved in removing the urethral stricture. Urethral valves are sail-like membranes that are located within the urethra and cause it to constrict. Meatal stenosis is the medical term applied to a narrowing of the opening of the urethra. Another of these congenital abnormalities is the aforementioned hypospadias, in which the patient is born with an unusually short urethra. An additional five percent of strictures are caused by a condition known as lichen sclerosus. This inflammatory skin condition involves hardening and…


Urinary stasis as a last warning

If a urethral stricture is continuously ignored despite clear symptoms in the body of the affected person, it will eventually lead to urinary stasis. Urinary stasis describes a complete blockade inside the urethra that prevents the patient from urinating at all. A longer urinary stasis makes the urine to back up as far as to the kidneys. This will cause severe pain and can eventually lead to a complete kidney failure if it remains unattended. At this point, the patient’s life is in acute danger and requires immediate medical attention. Such a situation can easily be avoided: men should seek the help of a urologist at the first sign of…


Accidents as a cause for urethral stricture

Accidents can also be a cause for urethral stricture. There are several accidents, which are considered to be distinctive for suchlike injuries. There are pelvic fractures, for example, or blunt traumas of the genital areas as well. These so called straddle traumas can be induced by falling off a bike, for instance. In consequence of the damage the urethra can be injured, too, or at worst it could tear. In the event of a minor injury, the subsequent scarring of the tissue can eventually lead to a urethral stricture.


Inflammation as a cause of urethral stricture

An inflammation of the urethra can lead to urethral stricture. In twenty percent of the cases the so-called urethritis is a cause of the urethral stricture. One reason for such a bacterial inflammation of the urethra may be the gonorrhea. Gonorrhea is a sexually transmitted disease that is in many cases the cause of urethral stricture due to inflammation.