The urethra is the tube that continues from the urinary bladder and allows the passage of urine — and in men, also semen. The male urethra follows an “S”-shaped course and is approximately 25–27 cm long, whereas in women, the urethra is straight and significantly shorter, about 5–7 cm in length.
Urethral stricture is a condition in which the urethral lumen becomes narrowed due to the formation of fibrotic (scar) tissue. The narrowing can occur at any point along the urethra and can vary in length. Although it can affect individuals of all ages and both sexes, it is more commonly seen in men.
The main symptoms of urethral stricture include reduced urine flow, difficulty urinating, and a sensation of incomplete bladder emptying. These symptoms are often similar to those seen in men with benign prostatic hyperplasia (BPH), and may be accompanied by frequent urination, nocturia (urination at night), and an intermittent urinary stream. Dysfunctional urination can also increase the risk of developing urinary tract infections, whether uncomplicated or complicated.
Urethral strictures are rarely congenital — that is, present from birth. In most cases, the cause is iatrogenic, meaning the result of medical procedures involving the urethra. These may include simple catheter placement, diagnostic cystoscopy, or transurethral interventions to treat prostate enlargement or urinary stones. Any manipulation of the urethra has the potential to result in scar tissue formation and subsequent narrowing.
Additionally, urinary tract infections, especially urethritis caused by common or sexually transmitted bacteria, can lead to urethral strictures. Trauma, such as pelvic fractures or straddle injuries (particularly in children), are also recognized causes.
Surgeries involving nearby structures — such as radical prostatectomy or radiation therapy in the pelvic area — can lead to strictures, particularly in the posterior urethra. Finally, diseases affecting the urethral meatus or surrounding skin, such as severe meatal eversion in women, lichen sclerosus of the glans penis, or phimosis in men, can also result in urethral narrowing.
The diagnosis of urethral stricture is made through specialized tests such as uroflowmetry, urethrocystography, and urethrocystoscopy.
This is the oldest and most widely used treatment method
It is performed under local anesthesia
It is associated with high complication rates (including bleeding, urinary tract infections, and urethral trauma) and a high recurrence rate
It requires frequent and regular repeat procedures, necessitating repeated visits to a hospital or private practice
It is indicated only in limited cases, such as short, isolated, and first-time strictures
Very low success rate, as low as 20%
A transurethral incision using specialized instruments
Performed in the operating room under anesthesia
Postoperative catheterization may last up to 4 weeks
Requires frequent repeat procedures, often in combination with catheterizations and urethral dilations, involving regular visits to a hospital or private clinic
High complication and recurrence rates, including bleeding, urinary tract infections, erectile dysfunction
Limited indications: suitable mainly for short, single, and first-time strictures
Very low long-term efficacy, with success rates as low as 20%
An open, invasive, and complex surgical reconstruction
Performed in the operating room under general anesthesia
A highly specialized and lengthy procedure, requiring significant surgical expertise
Hospitalization is necessary, with postoperative catheterization for up to 4 weeks, followed by a lengthy recovery period
Low complication rates, which may include bleeding, urinary tract infections, bruising, erectile dysfunction, urinary incontinence
Considered consistently effective over time, with cure rates exceeding 90%
A minimally invasive, endoscopic technique
Performed under conscious sedation (no general anesthesia required)
Indicated for the majority of urethral strictures
Immediately effective, with very low rates of side effects and complications
Combines mechanical dilatation with localized drug delivery (paclitaxel) to maintain urethral patency
Does not require general anesthesia, prolonged surgery, hospitalization, or postoperative catheterization
It combines the simplicity and immediacy of traditional dilations with the use of a specialized cytostatic agent — paclitaxel. This drug is delivered directly to the stricture site via a drug-coated balloon, helping to maintain urethral patency by preventing scar tissue formation and reducing the risk of recurrence.
Optilume® is suitable for both men and women and is indicated in the majority of urethral strictures. The procedure is extremely simple and minimally invasive, does not require general anesthesia, is completed in a short period of time, and typically does not require hospitalization. In most cases, a urinary catheter is used for just 24 hours post-procedure.
Compared to traditional techniques, Optilume® demonstrates superior efficacy, broader applicability, and significantly fewer complications. Its minimally invasive nature offers a major advantage over complex open surgical repairs, while still delivering high success rates with minimal side effects. Thanks to its outstanding clinical outcomes, ease of use, and broad range of indications, Optilume® is increasingly regarded as the treatment of choice for urethral strictures. Extensive clinical experience and robust international scientific evidence have led to its inclusion in the European Association of Urology (EAU) guidelines as a valuable and evidence-based tool in the hands of urologic surgeons.
Ιατρικό Διαβαλκανικό Κέντρο, Θεσσαλονίκη
Ιατρικό Κέντρο Αμαρουσίου, Αθήνα
Ευρωκλινική Αθηνών
Therapis Hospital – Αθήνα
EUROMEDICA – Ρόδος
Ιατρικό Κέντρο Φαλήρου
Ιατρικό Κέντρο Αμαρουσίου, Αθήνα
Metropolitan General, Αθήνα
401 Γενικό Στρατιωτικό Νοσοκομείο Αθηνών
Ιατρικό Κέντρο Αμαρουσίου, Αθήνα
Metropolitan Φαλήρου
Metropolitan General
Αττικό Νοσοκομείο, Αθήνα
