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As many men get older, they start to have different urinary symptoms. Whether that’s waking up multiple times at night to use the restroom, noticing the force of their stream isn’t what it used to be, or having to go more frequently than some of their peers — these are common issues.
This can be due to an enlarged prostate, but another, lesser-known cause is called a urethral stricture. That’s basically scar tissue that builds up inside the urinary tract — or, as I often describe it to patients, “inside your plumbing system.” This condition requires a completely different mindset for management compared to something like an enlarged prostate.
If you’re diagnosed with a urethral stricture and come to my office, we’ll start with one of two things. We’ll either do a cystoscopy in the office — a simple camera study where we pass a small camera into your bladder to look for scar tissue — or, if we can’t advance the camera due to a blockage, we’ll take X-rays instead. After that, I’ll review your images with you, and we’ll sit down to discuss the different treatment options available.
Some of the non-surgical options include dilation — teaching a patient to pass a small catheter to continually stretch the scar tissue and relieve symptoms.
Among the surgical options, one is a drug-coated balloon procedure. This is an outpatient procedure that usually takes about 10 to 15 minutes. We go in, stretch the scar tissue with a balloon, and the medication coating helps prevent the scar from reforming. This is a fairly new technology at the forefront of urethral stricture management, and I’m happy that we offer it here at UAMS.
For more advanced cases, we may consider urethroplasty, a surgical reconstruction of the affected area. This can range from simply cutting out the scar tissue and sewing the two healthy ends back together, to a more complex procedure where we take tissue from the inside of your cheek and use it to rebuild that section of the urethra.
For patients dealing with urethral strictures, I believe UAMS is the perfect place for care. I’m currently the only provider in Arkansas who is specially trained to treat urethral strictures. I completed a fellowship in urethral reconstruction — or male reconstructive urology — at UT Southwestern in Dallas, Texas, where I performed hundreds of stricture cases during that year. I continue to see and treat these conditions regularly in my day-to-day practice.
