A urethral stricture is a medical condition characterized by the abnormal narrowing of the urethra—the tube that carries urine from the bladder out of the body. Scar tissue buildup inside the urethra restricts the normal flow of urine, leading to painful, weak, or incomplete urination. If left untreated, severe strictures can cause urinary retention, recurrent bladder infections, bladder muscle damage, and kidney failure.
Under the expert care of Dr Ramesh Hanumegowda, a renowned Urologist and Reconstructive Urology Specialist in South Bangalore with over 15 years of experience, patients receive accurate diagnostic evaluation and permanent reconstructive surgical solutions. Care is available across three state-of-the-art facilities: Spectra Clinic (Gubbalala / Kanakapura Road), Vasavi Hospital (Kumaraswamy Layout), and Neighbourhood Hospital (JP Nagar 7th Phase).
Urethral strictures can develop anywhere along the length of the male or female urethra. The primary causes of scar tissue formation include:
Straddle Injury or Trauma: Accidents involving bicycle crossbars, motorbikes, or pelvic fractures that crush the urethra.
Iatrogenic Causes: Scars resulting from prior urological procedures, prostate surgeries, or prolonged use of urinary catheters.
Infections: Untreated sexually transmitted infections (STIs) such as gonorrhea, or chronic inflammation like Balanitis Xerotica Obliterans (BXO/Lichen Sclerosus).
Congenital Factors: Rare structural abnormalities present from birth or complications from previous hypospadias repairs.
Idiopathic: In up to 30% of cases, the exact underlying cause of stricture formation remains unknown.
Symptoms usually develop gradually as the urethral lumen narrows:
Weak or Spraying Urine Stream: Significantly reduced urine flow, double stream, or spraying.
Straining to Urinate: Difficulty initiating or maintaining a steady stream.
Incomplete Bladder Emptying: A persistent feeling that the bladder is not fully empty after urinating.
Dribbling Post-Urination: Leakage of urine immediately after finishing.
Pain & Burning: Dysuria or lower abdominal/pelvic discomfort.
Recurrent UTIs & Prostatitis: Frequent urinary or prostate infections caused by stagnant urine.
Acute Urinary Retention: Complete inability to pass urine, requiring urgent emergency intervention.
Accurate evaluation of stricture length, location, and depth of scarring is crucial for choosing the right surgical approach. Dr. Ramesh performs comprehensive diagnostic assessments:
Uroflowmetry: Measures the velocity, pattern, and total volume of urine voided to gauge obstruction severity.
Retrograde Urethrogram (RUG) & Micturating Cystourethrogram (MCU): Specialized X-ray imaging techniques using dye to map the exact location, length, and degree of narrowing.
Diagnostic Cystoscopy: A thin, flexible endoscope is used to visually examine the urethral mucosa and exact stricture site.
Post-Void Residual (PVR) Ultrasound: Measures the volume of urine remaining in the bladder after urination to evaluate bladder strain.
Treatment selection depends on the stricture’s length, location, and whether it is a primary or recurrent stricture.
| Treatment Option | Procedure Description | Best Suited For |
| Urethral Dilation | Gradual stretching of the narrowed area using special sounds or balloons. | Temporary symptom relief or very short, non-dense strictures. |
| DVIU (Direct Visual Internal Urethrotomy) | Endoscopic procedure using a laser or blade to cut open the scar tissue. | Primary, single strictures under 1 cm in the bulbar urethra. |
| Anastomotic Urethroplasty | Surgical excision of the scarred segment, joining healthy urethral ends directly. | Short, traumatic strictures (1–2 cm) in the bulbar or membranous urethra. |
| Buccal Mucosal Graft (BMG) Urethroplasty | Reconstructive surgery using inner cheek tissue to widen the narrowed urethra. | Long (2+ cm), complex, or recurrent strictures (Gold Standard approach). |
Unlike simple endoscopic cutting (DVIU), which has high recurrence rates for long strictures, Reconstructive Urethroplasty offers long-term success rates exceeding 90–95%. Dr. Ramesh Hanumegowda specializes in complex Buccal Mucosal Graft (BMG) Urethroplasty, providing durable, lifelong relief for patients with complex urethral disease.
Patients seeking expert evaluation for urethral strictures can consult Dr. Ramesh Hanumegowda at the following South Bangalore locations:
Spectra Clinic (Gubbalala / Kanakapura Road):
Address: 48/2A, 80 Feet Rd, Friends Colony, Gubbalala, Subramanyapura, Bengaluru – 560061
OPD Hours: Monday – Saturday: 04:30 PM – 05:30 PM
Vasavi Hospital (Kumaraswamy Layout):
Address: 15, 70th Cross Road, Kumaraswamy Layout II Stage, Bengaluru – 560078
OPD Hours: Monday – Saturday: 10:00 AM – 04:00 PM
Neighbourhood Hospital (JP Nagar):
Address: 9, Kothnur Main Rd, RBI Layout, JP Nagar 7th Phase, Bengaluru – 560078
OPD Hours: Monday – Saturday: 06:00 PM – 07:00 PM
We’re here to listen, assist, and provide answers to all your inquiries.
Dr. Ramesh Hanumegowda is a highly respected Urologist with over 15 years of extensive surgical experience, known for delivering advanced, evidence-based urological care with precision and compassion. He holds an MBBS, MS in General Surgery, and MCh in Urology from the prestigious Institute of Nephrourology, Bengaluru, one of India’s leading centers for urological excellence.
Dr. Ramesh has a special clinical interest in urethral reconstruction and is a certified Da Vinci Robotic Surgeon, enabling him to perform complex urological procedures with enhanced accuracy, minimal invasiveness, and faster recovery for patients. His expertise spans a wide range of urological subspecialties, including Endourology, Kidney Transplantation, Robotic Urology, Reconstructive Urology, and Uro-Oncology.
A urethral stricture is an abnormal narrowing of the urethra caused by scar tissue buildup. It is commonly triggered by saddle injuries (accidents on bicycles or motorbikes), pelvic fractures, medical trauma from urinary catheters or prior surgeries, untreated infections, or BXO (Lichen Sclerosus).
The primary symptom is a progressively weak, double, or spraying urine stream. You may also experience severe straining during urination, a feeling that your bladder isn't fully empty, post-urination dribbling, frequent UTIs, or sudden urinary retention.
DVIU (Direct Visual Internal Urethrotomy) is a minor endoscopic procedure where the scar is sliced open. However, DVIU can have a high recurrence rate, particularly for long or dense strictures.
Urethroplasty is a reconstructive surgery that removes or rebuilds the damaged section of the urethra. It generally provides more durable results for appropriately selected patients.
BMG Urethroplasty is a reconstructive surgery commonly used for long or recurrent urethral strictures. It involves taking a small patch of tissue from the inner cheek lining (buccal mucosa) and using it to widen and reconstruct the narrowed portion of the urethra.
No external facial scar is created because the graft is harvested from the inside of the mouth. The inner cheek generally heals well, and temporary mouth soreness may occur after graft harvesting. Recovery varies from person to person.
Following reconstructive urethroplasty, a urinary catheter is commonly left in place for around 2 to 3 weeks, depending on the surgical technique and individual healing. The treating urologist will determine the appropriate catheter duration.
Yes. Severe or untreated urethral strictures can obstruct urine flow and increase pressure within the urinary tract. Prolonged obstruction may affect bladder function and, in severe cases, can contribute to kidney damage. Early evaluation and treatment can help prevent complications.
Evaluation may include Uroflowmetry to assess urine flow rate and pattern, Retrograde Urethrogram (RUG) and MCU X-rays to assess the location and extent of narrowing, and Diagnostic Cystoscopy for direct visualization of the urethra and urinary tract.
Urethroplasty is designed to restore urine flow while preserving surrounding structures. Most patients do not experience significant long-term sexual dysfunction, although temporary changes or other complications can occur. The potential effect on sexual function and fertility depends on the location of the stricture, surgical technique, and individual factors.
Patients can consult Dr. Ramesh Hanumegowda across three locations: Spectra Clinic (Gubbalala / Kanakapura Road), Vasavi Hospital (Kumaraswamy Layout), and Neighbourhood Hospital (JP Nagar 7th Phase).
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