Urethral strictures are a urological condition that can affect both men and women. Though this condition is rare for women, it is still a possibility. Urethral stricture affects the urethra of a person, which becomes narrowed due to this condition. The narrow urethra creates problems in voiding your bladder and can even cause pain while urinating or present blood in your urine. These strictures can have serious adverse effects on your health if left unchecked. So first, let’s look at the different causes of urethral stricture followed by urethral stricture in females and if it is different from urethral stricture in male.

What Are The Causes of Urethral Stricture?

Urethral strictures can be caused by anything that forces your urethra to constrict causing difficulty in urination. The causes can be similar for both men and women even with similar urethral stricture symptoms. There are a variety of causes that could lead to urethral strictures including common causes and even rare causes that are harder to diagnose. Let’s look at all the different causes of urethral stricture in detail.

Common Causes

Infections: 

Infections can be both, a caused of, and caused by urethral strictures. Let’s dissect what that means. Infections mainly sexually transmitted infections like chlamydia and gonorrhoea can cause scarring in your urethra that can lead to strictures. STIs cause inflammation in your urethra, which in turn causes scarring and blockage of the urinary tract. Infections are some of the most common causes of urinary strictures and due to the pain and discomfort they bring, it is hard to miss. As the infections related here are sexually transmitted, in most cases, they are preventable.

Now coming to how urinary strictures can cause infections. It works in a similar way to another condition known as Benign Prostatic Hyperplasia or BPH. Due to the blockage in your urinary tract, the accumulated urine in your bladder can cause urinary tract infections, which if left untreated can even cause kidney stones. Even without kidney stones, any infection in your body can affect your body’s immunity and your overall health, so it is very important that you get medical help to treat them.

Trauma or Injury: 

Injury to your urethra can be another common cause of urethral strictures. Pelvic fractures are specifically the type of injury that puts your body at risk for urethral strictures. Not only are these fractures extremely painful, but they can affect other parts of your urinary system too. The impact of a pelvic fracture can tear the urethra and cause scarring, which then leads to an urethral stricture. 

Based on the severity of the tear and the fracture, treatment processes vary greatly. Any stricture caused by pelvic fractures is more severe than others and requires immediate medical help for recovery. Apart from pelvic fractures injuries to areas near your scrotum or straddle injuries can also cause urethral strictures.

.Urethral strictures caused by pelvic fractures are more common for men, however, it is possible that women can get affected by them as well. Given the rarity of the condition, women with urethral stricture caused by pelvic fractures require special medical attention from experienced doctors and caregivers like the ones at MASSH.

Surgery & Catheters: 

The most common cause of urethral strictures is urinary catheters inserted into the urethra for easy emptying of your bladder. However, inserting foreign objects into the urethra can have adverse effects on your body. Namely inserting foreign objects like catheters can cause inflammation or infections in your urethra, which can lead to the formation of scar tissues and urethral strictures. 

Even with surgeries, the same risk stands. Surgical procedures performed in and around the urethra can cause infection or inflammation, which can cause urethral strictures. Often surgical procedures performed to treat other urinary conditions like BPH can lead to urinary strictures. While doctors work tirelessly to ensure patients don’t get any infections from their surgery, infections post-surgery are very common and often not the fault of your caregivers.

Congenital Causes: 

People can be born with a narrow urethra and that can form strictures as you age. In conditions like this, it is important to understand your risk factors and get medical help before you start showing symptoms. Having a narrow urethra is more common for men because they have a longer urethra, which can be narrow at any point from your bladder to the tip of your penis. With preventive care, it is possible to keep a narrow urethra from forming strictures.

Iatrogenic Causes: 

Iatrogenic causes refer to a previous point mentioned above, which is urethral strictures caused by surgical procedures performed in and around your urethra or post-surgery complications from urinary conditions. Some of the conditions that put you at the highest risk for urethral strictures are minimally invasive procedures used to treat conditions like BPH. The collateral risk of urethral strictures is one of the major long-term side effects/risks of BPH treatment. Specific surgeries like transurethral resection of the prostate (TURP) and urethral dilation, can cause strictures.

Rare Causes
 

Congenital Abnormalities

There are conditions like Hypospadias which is a congenital abnormality of the urethra that boys can commonly have by birth. This condition causes the urethra to not be properly aligned with the tip of the penis. This increases your chances of getting urethral strictures manyfold and can even cause difficulty in urination from an early age. This is a fairly rare condition that affects less than a lakh people in India annually. However, people with hypospadias are at a very high risk of developing urethral strictures at a young age, if not treated early.

Autoimmune Disorders

One of the most common autoimmune disorders known as systemic lupus erythematosus or SLE can be a rare cause of urethral strictures. SLE causes the immune system of your body to attack itself namely the tissues. It causes tissue damage, inflammation, and scarring in different organs of your body that are affected. The urethra can also be affected in the process and lead to urethral strictures.

Other conditions like sarcoidosis can also affect your urethra by growing tiny inflammatory cells in the region causing urethral strictures. These cases are very rare and treating them requires specialised medical aid and a team of highly qualified and experienced doctors.

Radiation Therapy

Radiation therapy used to treat pelvic or prostate cancer can rarely cause scarring in your urethral tissues leading to urethral strictures. Not only is this phenomenon rare but it can affect you years after you have received radiation therapy. There are no discernable ways to predict if radiation therapy will cause urethral strictures for you or not.

Inflammatory Conditions

In some cases, inflammatory conditions in your body like lichen sclerosis or urethral diverticulitis can cause urethral strictures. Lichen sclerosus is a condition that commonly affects menopausal women and causes white patchy skin in and around their anus and pubic regions. If left untreated it can cause inflammation in your urethra and cause urethral strictures. So, white patchy skin in your pubic region can be one of the major urethral stricture in female symptoms.

Similarly, diverticulitis is a condition that generally affects your digestive system. Rarely it can also affect your urinary system and cause inflammation in your urethra leading to conditions like urethral strictures. Both of these conditions are quite rare, but they can affect both men and women.

Neoplasms

Urethral strictures can be formed by tumours as well. These tumours can directly invade your urethra and cause strictures. Tumours can also indirectly cause strictures as your body might produce fibrous tissues in response to the tumour around your urethra, which ends up prohibiting the natural flow of urine out of your body. Tumours around your urethra can be dangerous because neoplasms can be both benign or malignant. In the case of the latter, the tumour can be cancerous and requires immediate medical attention.

These are the different causes of urethral strictures. However, even with such an expansive list, there are still cases of idiopathic urethral strictures where doctors are not able to pinpoint the exact cause behind the strictures. With that being said, let’s learn about the various risk factors of urethral strictures.
 

Risk Factors of Urethral Stricture

There are a variety of causes for urethral strictures as you now know. However, the list of risk factors for the same is not as long. Like other urinary conditions, age is definitely a risk factor for urethral stricture, but it is not the biggest risk factor. So what are the biggest risk factors? Let’s find out.

Sexually Transmitted Infections

Sexually transmitted infections are one of the most common risk factors for urethral strictures. Previously, gonorrhoea used to be the number one cause of urethral strictures. Thanks to antibiotics, the data has changed, but you still need to keep yourself safe from them to stay away from urethral strictures.

Urinary Infection

Urinary infections are different from STIs and are also a major risk factor for urethral strictures. No matter the cause behind the infection, if it is left unchecked, it can cause inflammation and strictures in your urethra. Common causes of urinary infections can also be other urinary conditions, which will be discussed later.

Recent Urethral Surgery Or Use of Urinary Catheter

Urethral surgery and the use of urinary catheters are the leading cause of urethral strictures today. Surgical processes always have the risk of infection and if you have recently had any surgeries in your urinary tract, it could cause urethral strictures. The use of urinary catheters is also a common cause of urethral strictures and as such need to be minimised as much as possible.

Pelvic Injury

Pelvic injury or straddle injuries can cause complicated cases of urethral stricture. Any form of serious injury or trauma can tear the urethra and create severe strictures, so stay safe from pelvic injuries whenever you can.

Benign Prostatic Hyperplasia

As mentioned earlier, urinary infections are often caused by other conditions, and one such condition is benign prostatic hyperplasia or BPH. Not only can having BPH increase your risk of urethral stricture, but even getting surgical treatment for BPH can increase your risk of urethral stricture. Men over the age of 50 have an almost 50% chance of getting BPH, so you need to take extra care of your urinary health to keep yourself safe from both of these conditions.

Conclusion

Getting medical attention regularly and keeping track of your symptoms and making yourself aware of the different conditions that you need to be aware of are some of the ways to keep yourself healthy as you age. So, if you want to learn more about the symptoms or treatment options of urethral strictures check out the MASSH website, or feel free to book an appointment and visit us. We specialise in treating all types of urethral stricture using modern minimally-invasive surgeries that minimise the risk of recurrence.