Penile obstruction: symptoms, causes and treatment

When you use the term “penile obstruction,” you are most likely describing a condition known as urethral stricture. This is a more medically specific explanation of what might be causing your symptoms.

A urethral stricture is a narrowing of the tube that carries urine and semen through the penis and out of the body.

A urethral injury, infection, or other medical condition can cause scar tissue to form inside the urethra, restricting the flow of urine and semen. This type of penile blockage or shrinkage can usually be treated with both surgical and non-surgical procedures.

Keep reading to learn more about this condition, including symptoms, causes, and treatment options.

In people of all sexes, the urethra is the thin tube through which the bladder empties urine. When a person with a penis ejaculates, semen also passes through the urethra. The urethra in a person with a penis is much longer than in a person with a vulva. Therefore, the risk of urethral problems is much higher if you have a penis than if you have a vulva.

A penile obstruction, or urethral stricture, develops when inflammation or injury irritates the inner lining of the urethra. This causes scar tissue to form, narrowing the opening through which urine flows. The result is that you may feel like your penis is clogged. A urethral stricture can form soon after an injury, such as a broken pelvis, or it can take months before symptoms develop.

Urethral stricture may affect only a short section of the urethra or a much longer part. The location and length of the urethral stricture will affect your treatment options and your symptoms.

When the usual, healthy flow of urine is diminished by urethral stricture, some of the following symptoms may develop:

  • slow and reduced stream of urine
  • painful urination
  • incontinence
  • dark urine
  • blood in urine
  • abdominal pain
  • penis swelling

A penile obstruction can occur anywhere along the urethra. Some of the most common causes of urethral stricture include:

  • injury to the urethra, sometimes caused by blunt force trauma, such as a bad fall or an injury that punctures the urethra
  • infection, such as a sexually transmitted infection (STI)
  • irritation caused by the placement of catheters in the urethra or by endoscopic procedures such as cystoscopy

In many cases, no specific cause of urethral stricture can be identified.

Your doctor will determine the right treatment approach for urethral stricture based on the severity of the problem and the size of the stricture. For example, they can treat a short stricture with urethral dilation or internal urethrotomy. Urethral reconstruction, a surgical procedure, can be used for longer strictures.

Urethral dilation

Urethral dilation begins with the placement of a very thin guidewire through the urethra. After that, progressively larger threads, called dilators, are threaded over the guide wire to stretch the sides of the urethra.

A study 2019 in the American Journal of Clinical and Experimental Urology suggests that guidewire urethral dilation is a safe approach that limits the risk of incontinence, especially when used to treat a short stricture.

Internal urethrotomy

During an internal urethrotomy, your surgeon will first insert an endoscope into the urethra to see the stricture. Then they will use a small, sharp surgical instrument, called an endoscopic scalpel, to open the stricture. They will do this in one or two places to increase the diameter of your urethra. Typically, they will also be placed through a urethral catheter after the procedure. The catheter encourages the narrowing to heal into the newly enlarged configuration.

Urethral reconstruction (urethroplasty)

A third treatment option is urethral reconstruction, also called urethroplasty. This is a surgical procedure that involves removing the constricted part of the urethra and reattaching the healthy parts of the tube. This approach is usually taken when longer sections of the urethra have been affected.

There are two types of urethroplasty:

  • Primary anastomotic urethroplasty. In this type of urethroplasty, your surgeon will cut out the diseased section that is causing the stricture and reattach the healthy ends. They will usually perform this procedure for narrowings of short segments.
  • Incision and graft, or ventral onlay graft. This type of urethroplasty is usually reserved for longer stricture segments. In this procedure, your surgeon will cut the narrowing from the lower side. Then they will use a piece of tissue to enlarge the diameter of the urethra. The tissue usually comes from the inner cheek, called the buccal mucosa.

Strictures that return more than once after treatment should be evaluated by a reconstruction specialist. They may recommend a more formal stricture repair.

If you notice that urination has become painful or if you are having more trouble emptying your bladder, see a doctor quickly. It can be a narrowing of the urethra or a number of other conditions, such as kidney stones or an enlarged prostate. Other urinary changes, such as blood in your urine or new incontinence, also require evaluation by a doctor.

It is important to pay attention to the symptoms of urethral stricture and discuss them promptly with a doctor. If urine backs up in the body, there is an increased risk of urinary tract infections involving the bladder or even a kidney. This can lead to potentially serious health complications. However, these infections are often effectively treated with antibiotics.

A narrowing of the urethra can also cause inflammation of the prostate, known as prostatitis. Prostatitis can also be treated with antibiotics and other medications and therapies.

The medical term for a penis clog is urethral stricture. A narrowing of the urethra can make urination difficult. Fortunately, doctors can usually treat this condition successfully. In some cases, a catheter-based procedure is sufficient, but if the stricture is longer, a surgical solution may be required.

Keep in mind that urethral stricture can come back, so work closely with your doctor — a urologist, if possible — to monitor and maintain the health of your urethra. Taking steps to reduce your risk of pelvic injuries and infections will also help.

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