Strictures

A urethral stricture is scar tissue that causes narrowing of the urethra and can make it difficult to pass catheters into the bladder. Urethral stricture development is significantly higher in men who manage their bladder with intermittent catheterisation. This may be related to the length of the urethra and the frequency that catheters are passed into the bladder, creating scar tissue.

Preventing strictures

Strictures can be prevented through the use of quality catheters with smooth eyelets.

Ample water-based lubrication along the full length, including products such as pre-lubricated or hydrophilic-coated catheters, will pass more smoothly through the urethra.

Some catheters have different style tips, such as rounded, angled, flexible or a combination. These have been designed to help pass the catheter through the urethra.

Avoid pushing the catheter into the bladder against resistance. Assess for the possibility of detrusor sphincter dyssynergia (DSD), if the person has an upper motor neurone injury or an enlarged prostate.

Management of strictures

Management of strictures should be done in consultation with a urologist. Intervention may require surgery to diagnose, assess and treat the stricture.

References

Hsieh JTC, McIntyre A, Loh E, Ethans K, Mehta S, Wolfe D, Teasell R. (2019). Epidemiology of Pediatric Spinal Cord Injury. In Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan VK, Loh E, Sproule S, McIntyre A, Querée M, editors. Spinal Cord Injury Rehabilitation Evidence. Version 7.0. Vancouver: p 1-274 bladder-management_final_v7-1.pdf