Urethral Strictures

Excerpt

A urethral stricture is an abnormal narrowing of the urethra, typically caused by scar tissue, leading to obstructive urinary symptoms. These strictures often arise from injuries to the urethral mucosa and the surrounding tissues. This common condition results in many office appointments, emergency room visits, and hospital admissions. Although urethral strictures can occur in both sexes, they are rare in women, resulting in limited guidelines for the diagnosis and treatment of female strictures.

In males, strictures can develop anywhere along the length of the urethra but are most often found in the bulbar urethra and can be due to many etiologies. The male urethra is divided into 2 portions—the anterior portion extends from the external urethral meatus to the distal membranous urethra and the posterior portion extends from the distal membranous urethra to the bladder neck. The urethra is contained within the corpus spongiosum, which lies in a groove below the 2 corpora cavernosa. The inside of the urethra is lined with stratified squamous epithelium. Please see StatPearls' companion resources, “Anatomy, Abdomen and Pelvis, Male Genitourinary Tract” and “Histology, Male Urethra,” for more information.

Anterior strictures account for 92.2% of cases, with the majority occurring in the bulbar urethra (46.9%), followed by the penile urethra (30.5%), a combination of the bulbar and penile urethras (9.9%), and finally, panurethral strictures (4.9%).

The 2002 World Health Organization Conference recommended a more specific descriptive terminology that divides the urethra into 7 segments—the urethral meatus, fossa navicularis, penile (or pendulous), bulbar, membranous and prostatic urethra, and the bladder neck.