Strictures
The longer male urethra has consequences.
Urethral strictures are a narrowing of the urethra (by scar tissue), the tube through which urine exits the body from the bladder. While both men and women can experience urethral strictures, they are significantly more common in men. The average male urethra is about 17 to 22 cm long, while the female urethra is significantly shorter, measuring approximately 3 to 6 cm.
AGE All (including male children)
6 men to 1 woman
Decreased Flow
Spraying
Pain
Incomplete Emptying
> Risk with Circumcision
Symptoms and Impacts
Symptoms
Symptoms of a urethral stricture can include difficulty urinating, a weak urine stream, pain during urination, spraying and even recurrent urinary tract infections. Most cases are very manageable with simple surgery. Complex cases, however, do require reconstruction.
In severe cases, the condition can lead to complete blockage of urine flow, as scar tissue can create a very narrow bore (rare, as the bore is usually still wide enough for urine to pass), necessitating immediate medical intervention.
While usually small in length, it is possible to have long and multiple structures.
Long-term implications of untreated urethral strictures can include bladder damage, kidney complications, and reduced quality of life due to chronic pain or discomfort. It is important to follow this up. Another condition with similar symptoms, which is more common, is Benign Prostate Enlargement (BPE) in men over 50.
MALE URETHRA
The male Urethra is very long and is thus divided into sections. Visualising can help see where a stricture is in the Urethra. Each section has different challenges.
SCAR TISSUE
What is really going on is that a scar has formed in the Urethra. This has occurred for numerous reasons. Narrowing the bore and bringing with it symptoms.
CAN YOU RECALL
The main causes of a stricture are well known. One of these can help find a diagnosis. It is important to be aware of the causes, as it could signal a man has a stricture.
Circumscision
Meatal stenosis
Meatal stenosis (a stricture at the tip of the penis) is considered a complication of circumcision, specifically when performed in infancy or left late. While it's rare in uncircumcised individuals, it affects roughly 5% to 20% of circumcised males to varying degrees. This can include children.
The primary theories for why this occurs include...
Loss of Protection: The foreskin naturally protects the meatus (the opening). Without it, the tip can rub against nappies or clothing, causing chronic irritation.
Ischemia: During circumcision, the blood supply to the frenular artery can sometimes be disrupted, leading to slight tissue scarring.
Meatitis: Constant exposure to urine (especially in a nappy) can cause inflammation at the opening, which eventually heals as restrictive scar tissue.
Meatal stenosis Symptoms
The "Sprinkler" Effect: A narrow, high-pressure stream of urine that may spray in different directions.
Upward Deflection: The stream often aims upward rather than straight.
Straining: Having to push to start or maintain urination.
Long Voiding Times: It takes a long time to empty the bladder because the "exit" is too small.
What Causes Urethral Strictures?
Unseen
Urethral strictures pose a significant health issue for men due to a combination of anatomical, behavioural, and medical factors. They are mostly unseen away from the meatus (tip of Penis). Raising awareness, therefore, is very important so that symptoms and timely medical advice can lead to effective management and treatment, allowing a male to maintain healthy urinary function.