Urethral Stricture Disease

Urethral stricture disease occurs when scar tissue narrows the urethra, blocking or slowing the flow of urine. This narrowing can begin with mild symptoms such as a weak stream or difficulty starting urination, but without proper treatment it may progress to recurrent infections, bladder or kidney damage, and even urinary retention or incontinence. Unlike routine urinary issues that may improve with conservative care, strictures are a structural problem that almost always require specialized evaluation.

Many people struggle with repeated treatments that offer only short term relief, and in many cases the stricture returns after standard care. Because strictures are often more complex than they appear, choosing a center with advanced reconstructive expertise is essential. At The Institute for Advanced Reconstruction, our team specializes in identifying the true cause of the stricture and providing durable solutions that restore healthy urine flow, relieve discomfort, and prevent serious long term complications.

• Slow or weak urine stream requiring straining 
• Difficulty starting or stopping urination
• Frequent urinary tract infections (UTIs)
• Pain or burning with urination
• Incomplete bladder emptying
• Blood in the urine (in some cases)
• Inability to urinate (in severe cases)

If you’ve been experiencing these symptoms, early diagnosis and treatment can prevent long-term damage and improve quality of life.

Urethral strictures usually develop when the urethra has been injured, irritated, or scarred. In many cases, patients don’t realize a past event or treatment contributed until symptoms appear later. Risk factors include:

• Trauma: A pelvic fracture, fall, or direct blow can damage the urethra and leave behind scar tissue.
• Infection: Certain infections may cause inflammation that narrows the urethra over time.
• Medical procedures: Prior catheter use or surgery involving the urethra can sometimes result in scarring.
• Inflammatory conditions: Chronic irritation in the urinary tract can also lead to narrowing.

At The Institute, we see many patients with strictures that have recurred after previous treatments. Our team is uniquely trained to identify the underlying causes and provide long-term solutions.

Many patients come to us after other treatments have failed. Our team specializes in advanced surgeries that many centers don’t perform, often achieving lasting relief that greatly enhances quality of life.

Each patient’s case is unique, and we tailor your treatment plan to your needs. Options may include:

Urethral Dilation or Endoscopic Incision
A small instrument or scope is used to gently stretch or cut scar tissue to temporarily open the urethra. In some cases, an Optilume® drug-coated balloon may be used to help reduce scar-tissue regrowth. While these approaches can provide symptom relief, they may not prevent strictures from returning over time.

Meatoplasty 
Some patients experience narrowing of the opening of the urethra at the tip of the penis. This may sometimes be seen in conjunction with phimosis (the ability to retract the foreskin). A meatoplasty opens up the narrowing sometimes with the use of grafts. A concurrent circumcision can be discussed if applicable. 

Urethroplasty
Considered the gold standard, this surgery removes scar tissue and reconstructs the urethra to restore normal urine flow. Urethroplasty offers the highest long-term success rates.
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Buccal Graft Urethroplasty
In more complex cases, tissue from the inside of the cheek is used to rebuild the urethra. This graft helps restore structure and function when the stricture is long or severe.
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Secondary (Re-do) Urethroplasty
For patients whose strictures return after prior treatment including primary urethroplasty, our surgeons perform advanced repairs tailored to each patient’s anatomy and history. These procedures often succeed where others have not.
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Which option is right for you depends on the location and severity of the stricture, as well as your health and goals. Our team will guide you through your choices and recommend the approach most likely to give you lasting relief.

You may be a candidate for surgery if:

• You have ongoing symptoms that interfere with daily life
• You’ve experienced repeated urinary tract infections or retention
• Less invasive treatments haven’t worked, or your stricture keeps coming back

Do all strictures require surgery?

Not always. Some can be managed temporarily with dilation or endoscopic incision. However, strictures often come back after these treatments. Urethroplasty offers the best long-term results and is considered the gold standard.

How long will I need a catheter after surgery?

Most patients will have a catheter for 2–3 weeks while the urethra heals. Your surgeon will provide clear instructions and follow-up care during this period.

What is recovery like?

Most patients return home within a few days of surgery and can resume light activities within 2–4 weeks. Full recovery takes longer, but many patients notice significant improvement once the catheter is removed. Our team will guide you through every stage.

Will insurance cover urethroplasty or related procedures?

In most cases, yes. Urethral reconstruction is generally considered medically necessary. Visit our insurance information page for more information, or contact our financial coordinators to confirm your coverage.

Do I need a referral to see a specialist at The Institute?

No referral is required. Patients may request an appointment directly. If another doctor referred you, we will collaborate with your care team to ensure seamless communication.

What if I already had surgery and my stricture came back?

You’re not alone. Many patients come to us after failed prior treatments. Our surgeons are recognized experts in redo and complex urethral reconstructions.

How do I know if The Institute is the right place for me?

Patients travel to us from across the country and around the world because of our rare expertise in pelvic and urologic nerve surgery. If you’ve been struggling without answers, our team can provide a clear diagnosis and treatment plan.