This handout is for urethral stricture disease (bulbar / penile / pan-urethral / lsa / iatrogenic / post-traumatic / pediatric / bladder-neck-contracture). Your care team identified this based on: progressive weak stream / hesitancy / straining / spraying / incomplete emptying — possible usd (aua male urethral stricture 2017 pmid 27993339).
Other reasons your team may use this plan: inability to void with palpable bladder — aur; route to uro.acute-urinary-retention.v1 for stat decompression; recurrent uti in adult man with weak stream → stricture workup; route to uro.uti.complicated.v1 overlap; prior straddle injury or pelvic fracture → bulbar (straddle) or membranous (pelvic fracture urethral injury — pfui) stricture.
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| Urethral dilation (sequential filiform-follower or balloon) | — | — | — | AUA 2017 — short-term symptom relief; low durability; bridge to definitive (PMID 27993339; PMID 23416644) |
Plan: AUA 2017 — dilation → DVIU (first / short bulbar) → urethroplasty (definitive — anastomotic / substitution / flap) + LSA topical clobetasol + bladder-neck-contracture endoscopic + pediatric peds-uro
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Annual uroflow + symptom score; LSA lifelong derm surveillance; counsel recurrence rate (5-yr ~10% urethroplasty, 30–50% DVIU); pediatric — follow growth + repeat eval (AUA 2017)
Guideline: AUA Male Urethral Stricture 2017 (+ 2023 amendment) + EAU Urethral Strictures Guideline 2024 + Post-RP UI sling for bladder-neck-contracture overlap + AAP / Peds Uro hypospadias