Strettoia uretrale: restringimento del lume uretrale

Ultimo aggiornamento: 18 maggio 2026

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Urethral stricture is a common presentation at my urology office, defined as a narrowing of a segment of the urethra. US data reports a 0.9% incidence in men, with dramatically increasing prevalence after age 65.

• Centro di urologia Ospedale di Bangkok Thailandia Prenotazione online 02-310-3009 bhquro@bdms.co.th
• Ospedale Samitivej Sriracha Chonburi 088-022-1445

The 4 major causes of urethral stricture

1. Idiopatico (33% incidence) — more common in younger males; likely represents unrecognized childhood trauma or congenital anomaly
2. Iatrogeno (33% incidence) — history of transurethral endoscopic surgery or long-term indwelling urethral catheter
3. Infiammatorio (15% incidence) — history of urethral infection, particularly sexually transmitted diseases (STDs)
4. Traumatico (19% incidence) — blunt straddle injury, pelvic fracture, or penile fracture

Regardless of the cause, urethral damage triggers scar formation that gradually narrows the urethral canal over weeks, months, or years. Patients typically present with weak urinary stream or discomfort during urination. Evaluation involves flexible cystoscopy as first-line visualization, followed by retrograde urethrography (contrast study) if needed to define the stricture length and location.

Treatment options for urethral stricture

1. Dilatazione uretrale — serial dilation with metallic dilator; comparable results to surgery but 60% recurrence rate at 48 months follow-up
2. Uretrotomia a lama fredda a visione diretta — endoscopic incision of the stricture under direct vision; 50% recurrence rate at 48 months
3. Uretrotomia laser a visione diretta — same approach as cold knife but using laser technology; comparable outcomes
4. Uretroplastica — gold standard for strictures longer than 2 cm; highest long-term success rate of all treatment options

Since urethral stricture involves natural scar formation, recurrence is always possible regardless of treatment. Regular follow-up and early detection of recurrence are essential components of long-term management. Treatment choice depends on stricture length, location, etiology, and patient factors.

Frequently Asked Questions About Urethral Stricture

What causes urethral stricture?

Urethral stricture develops from scarring of the urethral wall following tissue damage. The four major causes are: idiopathic (33%) — often related to unrecognized childhood trauma or congenital anomaly; iatrogenic (33%) — from transurethral surgery or long-term catheterization; inflammatory (15%) — from urethral infection or sexually transmitted diseases; and traumatic (19%) — from pelvic fracture, straddle injury, or penile fracture. Regardless of cause, the resulting scar tissue gradually narrows the urethral lumen over weeks to months.

What is the best treatment for urethral stricture?

Treatment selection depends on stricture length and location. For short strictures, options include urethral dilation (60% recurrence at 4 years) or direct vision urethrotomy (cold knife or laser, 50% recurrence at 4 years). For strictures longer than 2 cm, urethroplasty (open surgical reconstruction) is the gold standard, offering the highest long-term success rate. Since all treatments carry a risk of recurrence due to the body’s natural scarring process, regular urological follow-up is essential after any treatment.

What symptoms suggest urethral stricture?

The most common symptom is a progressively weakening urinary stream. Other symptoms may include urinary hesitancy, incomplete bladder emptying (post-void dribbling), straining to urinate, discomfort during urination, recurrent urinary tract infections, and in severe cases, acute urinary retention. If you have a history of pelvic trauma, STDs, prior catheterization, or endoscopic urological surgery and notice changes in your urinary stream, prompt urological evaluation is important.

If you are experiencing urinary symptoms that may be caused by urethral stricture, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Prenota una consulenza.

Disclaimer: Questo contenuto è redatto e revisionato dal Dr. Soarawee Weerasopone, urologo certificato presso il Bangkok Hospital Headquarters. È inteso solo a scopo educativo e non costituisce consulenza medica. Consultare sempre un professionista sanitario qualificato prima di iniziare qualsiasi trattamento medico.