Urethral Stricture

A urethral stricture is a scar-based narrowing of the urethral lumen. In the male urethra, fibrosis affects the lining and the underlying corpus spongiosum, making the segment less elastic and progressively harder to open during urination. A small further reduction in diameter can produce a disproportionate loss of urinary flow, much like a pinched hose that suddenly delivers only a trickle. The result is obstructive lower urinary tract symptoms. A person may first notice a weaker or spraying stream, hesitancy, straining, prolonged voiding, or a sensation that the bladder has not emptied. As narrowing advances, residual urine increases and the person may develop frequency, urgency, dysuria, recurrent urinary infection, or acute urinary retention. A history of urethral instrumentation, pelvic or perineal trauma, urethral infection, radiation, or inflammatory skin disease increases suspicion. The history matters because a gradually deteriorating stream after prior urethral injury is not explained as well by a short episode of cystitis. Benign prostatic enlargement and neurogenic bladder can also obstruct or impair emptying, so symptoms alone do not establish the diagnosis. The nurse's first clinical distinction is...