Urethral Stricture Treatment

January 21, 2026

This page was reviewed under our medical and editorial policy by Humberto Villarreal, M.D., assistant clinical professor, Division of Urology and Urologic Oncology, Department of Surgery, City of Hope^® Cancer Center Duarte.

Urethral strictures occur when scar tissue causes the urethra to become narrower than usual. Because urethral strictures are far more common in men, the information below focuses only on treatments for male patients.

In cases where a urethral stricture is relatively small (less than 1 centimeter in length), the care team may recommend using dilation to manage the condition. Dilation involves inserting progressively larger catheters or a dilating balloon into the urethra in order to widen the area where the stricture is located. If this is not effective, there are a variety of surgical options.

Treatments for Bulbar Strictures

Bulbar urethral strictures are the most common type treated by urologists. They may be caused by trauma to the urethra, infection or having previously undergone a procedure that involved inserting an instrument into the urethra.

For patients with short, easily visible strictures, one possible treatment is a direct visual internal urethrotomy (DVIU). During this procedure, a surgeon incises the scar endoscopically and allows the urethra to heal with a catheter in place. Patients should only have one DVIU, as repeating the procedure can make later urethroplasties less effective.

A urethroplasty is the most common surgery used to repair a urethral stricture. There are two main types of urethroplasty for bulbar urethral strictures, which are listed below.

Anastomotic urethroplasty, also called excision and primary anastomosis: During this procedure, a surgeon cuts out the scar tissue in the urethra and reattaches the healthy tissue surrounding it. This is the best option for traumatic and short strictures. Anastomotic urethroplasty has a high rate of success.

Buccal mucosa urethroplasty: This procedure opens the urethra and patches the narrow area with tissue taken from elsewhere in the body – usually the inside of the mouth (buccal mucosa). Skin taken from the penis or other sites on the body may also be used. This is the best option for long strictures or strictures at multiple places.. It may also have fewer sexual side effects than an anastomotic urethroplasty.

Treatments for Bladder Neck Contractures

Bladder neck contractures typically form after receiving prior treatment for an enlarged prostate, particularly laser treatments and button transurethral resection of the prostate. They can also occur in patients who have had their prostate removed surgically, if scar tissue forms at the site where the bladder is sewn back to the urethra.

The first treatment option for this type of urethral stricture is a transurethral incision of the bladder neck contracture, which involves making an incision through the stricture. In some cases, doctors may inject a small dose of chemotherapy to prevent the scar from returning.

There are also emerging techniques for endoscopic incision and repair of the bladder neck contracture. For instance, the care team may suggest suturing healthy bladder/urethral tissue together to improve healing at increased success rates comparable to open or robotic assisted reconstructive surgery.

In cases of radiation-induced (or -associated) strictures, this type of procedure is less effective.

Advanced cases of bladder neck contractures often require more aggressive treatment. This approach may include robotic assisted or open surgery to establish patency. If surgery is not an option, a Foley catheter may be placed to aid bladder drainage.

Treatments for Pelvic Fracture Urethral Injury (PFUI)

Pelvic fracture urethral injury (PFUI) is a condition associated with a pelvic bone fracture, usually due to a car accident. When the pelvic bone breaks, the urethra may be torn in half. Often, a catheter is placed even after the injury. In other cases, the urethra is injured so severely that a tube has to be placed into the bladder through the skin of the low abdomen.

Determining the best treatment for repairing a PFUI usually involves imaging and consultation with -a reconstructive urologist.The definitive treatment is to perform an anastomotic urethroplasty, focusing on removal of all scar tissue in the urethra.

Treatments for Penile Urethral Stricture and Pan-urethral Strictures

Penile or pan-urethral strictures can be caused by a number of issues, including failed surgery for the condition hypospadias, the use of an instrument to perform a procedure on the urethra, lichen sclerosis (a scarring disease of the penile skin and urethra), infection or trauma. They can occur anywhere along the penile urethra.

The preferred treatment for penile urethral and pan-urethral strictures is a buccal graft urethroplasty. This is a procedure where buccal tissue is placed anywhere within the urethra, even extending the entire length of the urethra. This option is particularly effective for patients with lichen sclerosis, since their penile skin is often affected by the disease and cannot be used when grafting.

In the case of a failed hypospadias surgery (a procedure to correct a birth defect where the urethra is not located at the end of the penis), or when a patient has had a previous failed urethroplasty, this procedure is performed in stages. The first stage involves opening the urethra and sewing it to the skin. The second stage is creating a new urethral tube with the help of buccal grafts.

In certain cases, penile skin may be used to widen the narrowed urethra, but this option poses a higher risk of complications.

In severe cases, a perineal urethrostomy may be necessary. This procedure involves creating a new opening for the urethra within the skin of the perineum (the area between the anus and scrotum), which allows for normal bladder control, but does require that a man to sit to urinate. This is a highly effective choice but is often considered a last resort.

Treatment Options for Meatal Stricture

Meatal stricture is a narrowing at the very end of the urethra, at the tip of the penis. These strictures can be caused by trauma, lichen sclerosis, procedures that involve inserting an instrument into the urethra, infection or a failed urethroplasty. Although these strictures seem simpler, proper imaging is still required to determine the best course of treatment.

One option is meatoplasty, which is a procedure to make a small incision on the underside of the head of the penis, making the urethral opening larger. This is an effective option for small, short strictures. When the stricture extends into the fossa or penile urethra, it is normally treated using a similar way to strictures of the penile urethra.

What to Know Before Treatment

For anyone who has been told they have a urethral stricture, it is important to know that:

• All strictures should be properly imaged prior to any surgery.
• Dilations and incisions should only be performed on short strictures.
• Repeat dilations and incisions don’t cure the problem and may make future urethroplasty less effective.
• The current standard of care is imaging, followed by one incision or dilation and then a urethroplasty.

Urethral Stricture Treatment at City of Hope

At City of Hope, our highly skilled urology team, which includes fellowship-trained urologists who specialize in the repair of male urethral strictures, creates personalized treatment plans for every patient.