Urethral Stricture in Singapore

Written & reviewed by the BestDoctors.sg editorial team · Last updated 1 Sep 2026 · General information, not medical advice

A stricture can look, at first, just like an enlarged prostate – the same weak stream and straining. The difference matters, because the treatments are quite different, so a proper diagnosis is worthwhile.

What it is

The urethra is the tube that carries urine from the bladder to the outside of the body. A stricture is a segment of that tube that has become narrowed by scar tissue – a process doctors call fibrosis. The scar involves not only the inner lining but the spongy tissue around it, tightening the channel like a kink in a hose. As the opening narrows, urine cannot flow freely, so the bladder has to squeeze harder to push urine through. Over time this extra effort can thicken and weaken the bladder muscle and leave urine behind after voiding.

Because the male urethra is long and passes through the penis and prostate, while the female urethra is short, strictures are far more common in men and uncommon in women. A stricture can occur anywhere along the length of the urethra, and it may be a single short narrowing or a longer segment, which affects how it is best treated.

Causes

Causes include injury or trauma – a “straddle” injury (falling astride a bar or crossbar), a blow to the perineum, or a pelvic fracture that tears the urethra. Infection or inflammation is another route, including some sexually transmitted infections (such as gonorrhoea and chlamydia) and skin conditions such as lichen sclerosus, which can scar the opening and the surrounding tissue.

Previous procedures are a common modern cause: an indwelling catheter, an endoscopic operation, repeated instrumentation of the urethra, or earlier surgery can all leave scarring. Radiotherapy to the pelvis and, rarely, cancer of the urethra can also produce a narrowing. In a large share of men no clear cause is found, and the stricture is called idiopathic.

Who is at risk

Because of the anatomy, being male is the single biggest factor. Risk is higher in men who have had a pelvic or straddle injury, who have needed a urinary catheter or urethral instrumentation, who have had recurrent urethral infections or a sexually transmitted infection, or who have lichen sclerosus. Men who have had previous urethral or prostate surgery, or pelvic radiotherapy, are also more prone to strictures. Boys born with certain urethral abnormalities can develop strictures later in life.

Symptoms

Common symptoms are a weak or slow stream, a stream that sprays or splits or points in an odd direction, straining to urinate, a feeling of incomplete emptying, frequency and urgency, dribbling at the end, and getting up at night to pass urine. Some men notice discomfort or a burning sensation when voiding, blood in the urine or semen, or a reduced force that has crept up slowly over months or years.

Because the bladder never empties fully, stagnant urine can lead to recurrent urinary infections. In severe cases the flow can stop completely (acute urinary retention) – the bladder fills but nothing comes out. This is an emergency and needs urgent care.

Diagnosis

Assessment starts with your history and an examination. Tests include uroflowmetry (a flow test, in which you pass urine into a special funnel that measures the strength and pattern of the stream – a stricture typically gives a low, flat, plateau-shaped trace) and a bladder scan to check how much urine is left behind afterwards.

A retrograde urethrogram – an X-ray taken while dye is gently introduced into the urethra – maps the exact location, length and severity of the narrowing, which guides treatment. Cystoscopy, in which a thin flexible camera is passed into the urethra, lets the doctor see the stricture directly. A urine test is usually done to check for infection, since infection is common with obstruction.

Complications

Left untreated, the back-pressure and incomplete emptying from a stricture can cause several problems. Repeated urinary infections are common, and stagnant urine can encourage bladder stones. The bladder muscle can thicken and become overactive or, later, weak and poorly emptying.

In more severe or long-standing cases, pressure can travel back up to the kidneys, causing swelling of the kidney (hydronephrosis) and, rarely, a decline in kidney function. Abscesses or leakage of urine into surrounding tissue can occur. The most acute complication is complete inability to pass urine, which requires emergency treatment.

Treatment

Treatment depends on the length, location and number of strictures, and on whether it is a first occurrence or a recurrence. The options form a ladder. Dilation stretches the narrowed segment with progressively larger instruments – it is simple and can give relief, but the stricture often recurs. Optical urethrotomy is an endoscopic procedure in which the scar is cut from the inside under camera guidance; it offers good short-term relief but has a significant recurrence rate, especially for longer or repeated strictures.

Urethroplasty is open surgical reconstruction – the scarred segment is removed and the urethra rejoined, or the channel is widened using a graft (often from the inner cheek) or a flap. It is more involved than the other options but gives the best long-term cure rate and is generally preferred for recurrent strictures or longer segments. In some men, a temporary catheter or a supra-pubic tube (draining the bladder through the lower abdomen) is used while a plan is made or while the tissue heals. Because strictures can come back, follow-up – often with flow tests and a review of symptoms – is an important part of care.

Living with it and follow-up

Many men do well after treatment, but a stricture is a condition that can recur, sometimes years later. It helps to know your own early warning sign – usually the return of a weaker or spraying stream – and to seek review promptly rather than waiting for retention. Keeping well hydrated, treating urinary infections early, and attending follow-up flow tests all help. If you develop a new stricture or a recurrence, discuss with a urologist whether repeat endoscopic treatment or definitive reconstruction is the better path, as repeated dilations or urethrotomies for the same recurring stricture are often less effective than surgery.

When to see a doctor

See a doctor – a GP or polyclinic doctor, who can refer you to a urologist – if you have a persistently weak, slow or spraying stream, straining, a feeling of incomplete emptying, or recurrent urinary infections. Reliable general information for Singapore is available on HealthHub. Red flag: if you suddenly cannot pass urine at all and have a painful, full bladder, this is acute urinary retention – a medical emergency. Go to the nearest A&E without delay. Also seek urgent care for severe flank pain with fever, which may signal infection backing up to the kidneys.

Related kidney & urinary conditions

• Testicular cancer
• Urinary retention
• Hydronephrosis (kidney swelling)
• Bladder stones
• IgA nephropathy
• Kidney function tests & eGFR
• Renal artery stenosis
• Diet for chronic kidney disease
• Living kidney donation
• Chronic kidney disease
• Enlarged prostate (BPH)
• Urologists in Singapore
• Nephrologists in Singapore
• TURP & Laser Prostate Surgery

Sources

• Urology Care Foundation (American Urological Association) — urethral stricture disease: symptoms, causes, complications, treatments.
• AUA urethral stricture guideline — urethroplasty gives the best cure rate and is preferred for recurrent strictures.
• EAU guidelines — diagnostic evaluation: uroflowmetry, retrograde urethrogram, cystoscopy.
• Cleveland Clinic — urethral stricture: scar-tissue narrowing, symptoms and management. NUH (Singapore) urology — local assessment/treatment.