The urethra is the tube running from the base of the bladder to the tip of the penis in men and out the superior portion of the vagina in women, serving as a conduit for urine and sperm in men and urine for women.

Urethral strictures are scars that can occur anywhere in the urethra, causing stenosis (narrowing) of the urethra, which can lead to difficulty urinating, recurrent urinary tract infections and sexual dysfunction among other things. Causes of urethral strictures include:

• Perineal trauma
• Prior urologic procedures performed through the urethra
• Sexually transmitted diseases
• Pelvic irradiation for cancer
• Hypospadias
• Previous surgery for hypospadias
• Lichen sclerosus

Furthermore, pelvic trauma associated with pelvic fracture can cause a separation of the urethra (pelvic fracture urethral injury or PFUI) just below the bladder and prostate, creating an extensive scar.

Who is affected by lower urinary tract reconstruction?

Patients with severe bladder dysfunction caused by conditions like neurologic disease, urethral strictures or stenosis or spinal cord injury may have need of urinary tract reconstruction. The specific treatment option depends on the nature of the bladder dysfunction and the clinical experience of the physician.

Coordinated treatment 

Northwestern Medicine urologists and urogynecologists offer surgical reconstruction of the lower urinary tract for conditions that include:

• Pelvic Prolapse
• Cystocele ("fallen bladder")
• Uterine prolapse
• Rectal and small bowel prolapse
• Concealed penis

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