A urethral stricture is a narrowing of the urethra, the tube connected to the bladder that allows the passing of urine. The narrowing reduces the flow of urine and makes it more difficult or even painful to empty the bladder. Urethral stricture is caused by injury, instrumentation, infection, and certain non-infectious forms of urethritis The condition is more common in men due to their longer urethra. Signs and symptoms The hallmark sign of urethral stricture is a weak urinary stream. Other symptoms include: Splaying of the urinary stream Urinary frequency Urinary urgency Straining to urinate Pain during urination Urinary tract infection Prostatitis Inability to completely empty the bladder. Some people with severe urethral strictures are completely unable to urinate. This is referred to as acute urinary retention, and is a medical emergency. Hydronephrosis and kidney failure may also occur. Complications Urinary retention Prostatitis Bladder dysfunction Urethral diverticulum Periurethral abscess Fournier's gangrene Urethral fistula Bilateral hydronephrosis Urinary infections Urinary calculus Causes Urethral strictures most commonly result from injury, urethral instrumentation, infection, non-infectious inflammatory conditions of the urethra, and after prior hypospadias surgery. Less common causes include congenital urethral strictures and those resulting from malignancy. Urethral strictures after blunt trauma can generally be divided into two sub-types; Pelvic fracture-associated urethral disruption occurs in as many as 15% of severe pelvic fractures. These injuries are typically managed with suprapubic tube placement and delayed urethroplasty 3 months later. Early endoscopic realignment may be used in select cases instead of a suprapubic tube, but these patients should be monitored closely as vast majority of them will require urethroplasty. Blunt trauma to the perineum compresses the bulbar urethra against the pubic symphysis, causing a "crush" injury. These patients are typically treated with suprapubic tube and delayed urethroplasty. Other specific causes of urethral stricture include: Instrumentation (e.g., after transurethral resection of prostate, transurethral resection of bladder tumor, or endoscopic kidney surgery) Infection (typically with Gonorrhea) Lichen sclerosus Surgery to address hypospadias can result in a delayed urethral stricture, even decades after the original surgery. Diagnosis Among ways to diagnose this condition is: Cystoscopy Urethrography Treatment Initial treatment usually involves urethral dilation (widening the tube) or urethrotomy, where the stricture is cut away with a cystoscope. Dilation and urethrotomy Urethral dilation and other endoscopic approaches such as direct vision internal urethrotomy (DVIU), laser urethrotomy, and self intermittent dilation are the most commonly used treatments for urethral stricture. However,