Urethral Strictures and Urethroplasty: What It Is, Why It’s Needed, and What to Expect – A Guide from UPNT

At Urology Partners of North Texas (UPNT), we understand that urinary problems caused by urethral strictures can be frustrating and impact your daily life. If you’ve been experiencing slow urine flow, difficulty urinating, or recurrent urinary tract infections, you may have a urethral stricture—a condition where the urethra becomes narrowed or blocked.

In some cases, a simple dilation or minimally invasive procedure can restore normal urine flow. However, for more severe or recurring strictures, urethroplasty may be the best long-term solution.

This guide will walk you through what a urethral stricture is, how it’s treated, and what to expect if urethroplasty is recommended.

What Is a Urethral Stricture?

A urethral stricture occurs when the urethra (the tube that carries urine out of the body) becomes narrowed or scarred, making it difficult for urine to flow normally.

Common Symptoms of a Urethral Stricture

Weak or slow urine stream
Difficulty starting urination
Urinary retention (feeling like you can’t empty your bladder completely)
Frequent urination or urgency
Recurrent urinary tract infections (UTIs)
Painful urination
Spraying or splitting of the urine stream

What Causes a Urethral Stricture?

A stricture forms when scar tissue develops in the urethra, which can be caused by:

Previous catheter use – Long-term catheterization can irritate and scar the urethra.
Trauma or injury – A pelvic fracture or direct impact to the perineum can cause scarring.
Infections (including STIs) – Some infections can lead to urethral inflammation and scarring.
Previous surgeries – Certain urological or prostate surgeries can cause urethral narrowing.
Radiation therapy – Treatments for prostate or bladder cancer can sometimes lead to strictures.

First-Line Treatment: Urethral Dilation & Minimally Invasive Procedures

Before considering surgery, your UPNT doctor may try less invasive treatments to widen the urethra and improve urine flow.

1. Urethral Dilation

2. Direct Vision Internal Urethrotomy (DVIU)

💡 If a stricture is short and mild, these treatments may be enough. However, for longer or recurrent strictures, urethroplasty offers the best long-term success.

When Is Urethroplasty Needed?

A urethroplasty is a surgical procedure to permanently repair a damaged or scarred urethra. It is recommended when:

Types of Urethroplasty at UPNT

1. Excision & Primary Anastomosis (EPA) Urethroplasty

2. Substitution Urethroplasty (Graft Repair)

3. Staged Urethroplasty

The Urethroplasty Journey: What to Expect at UPNT

Before Surgery

Initial Consultation – Your UPNT specialist will discuss symptoms, perform exams, and possibly order tests (such as uroflowmetry, cystoscopy, or imaging studies).
Preoperative Testing – You may need urine tests or imaging to assess the severity of the stricture.
Pre-Surgical Instructions – Your UPNT team will guide you on when to stop eating and drinking before surgery.

The Urethroplasty Procedure

Performed under general anesthesia.
Depending on the type, the surgery takes 45-90 minutes.
A small incision is made in the perineum (the area between the scrotum and anus in men) or on the penis, depending on location of the stricture
The stricture is either removed or reconstructed with a graft.
A temporary catheter is placed to allow healing (usually 1-2 weeks, depending on the complexity of reconstruction)

Recovery After Urethroplasty

You’ll go home the same day or after a short hospital stay (usually 1 night).
A catheter will stay in place for up to 2 weeks to allow healing.
Most patients return to light activity within 1–2 weeks.
Full recovery (including resuming strenuous activities) takes about 4 weeks.
Your UPNT doctor will schedule follow-ups to ensure proper healing.

FAQs About Urethroplasty at UPNT

How do I know if I need a urethroplasty?

If you’ve had multiple failed urethral dilations or ongoing urinary issues, urethroplasty is likely the best solution.

Is urethroplasty permanent?

Yes, it offers the best long-term success (90–95% success rate).

Will I need a catheter after surgery?

Yes, a catheter stays in for up to 2 weeks while the urethra heals.

How soon can I return to normal activities?

Light activities in 1–2 weeks, full recovery in 4 weeks.

Can strictures come back after urethroplasty?

Recurrence is rare, but if it happens, further treatment may be needed.

Will urethroplasty affect erections or ejaculation?

Most men do not experience long-term sexual issues, although ejaculation and erections may temporarily be affected (usually less than 3 months if at all)

Why Choose UPNT for Urethroplasty?

Expert Urologists – Our team specializes in urethral reconstruction and stricture management.
Advanced Surgical Techniques – We use minimally invasive and reconstructive methods for the best outcomes.
Comprehensive Post- Operative Care – Our focus is on your comfort, recovery, and long-term success.
Personalized Approach – Every patient receives a tailored treatment plan.

Schedule Your Urethroplasty Consultation at UPNT

If you’re struggling with urination issues due to a urethral stricture, UPNT’s expert urologists are here to help. Our goal is to restore normal, pain-free urination and improve your quality of life.