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Hematuria, leg swelling, stiff body. Cystoscopy found stricture in bulbous urethra. Does this need urgent evaluation?

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General & Family Physician
Practicing since : 2005
Answered : 2568 Questions
Dear Doctor,
In my recent cystoscopy done by Urologist, he noticed large stricture in bulbous urethera, he is not interested to evaluate further for exact size and location, dont know why, does hematuria and swelling on ankles,legs, stiffness in body like hard to stand up from chair,climbing on stairs,knees pain are related to stricture/ Does this need urgent evaluation and treatment/ does this have any treatment plan? after sex experiencing severe pain in anal,feeling like to have sit on toilet seat, confused.
Posted Mon, 21 May 2012 in Urinary and Bladder Problems
Answered by Dr. Prasad 18 hours later


Thanks for the query.

It would have been better if you mentioned whether or not you have any difficulty / pain while passing urine.

Urethral strictures are result of congenital abnormality, past urethral injuries, infections and iatrogenic (past urethal instrumentation). Less commonly they can occur due to other inflammatory condition and tumour. If they asymptomatic, then it is more likely benign and are usually untreated.

Sometimes, thetrictures can cause symptoms such as difficulty to pass urine, pain while passing urine and precipitate infection. Hematuria is a rare symptom and very unlikely. Pedal oedema may occur if accompanied with difficulty in urination. The other symptoms of stiffness of body, knee pain and difficult in climbing stairs, pain during sexual contact are not related to urethral stricture.

As bulbous strictures are often reported as congenital, leaving it alone was a good decision. Your urologist did a good job. We can plan for further evaluation after repeating cystoscopy if urinary symptoms occur.

Hope this answers your query. Let me know if you have any further queries.

Above answer was peer-reviewed by
Follow-up: Hematuria, leg swelling, stiff body. Cystoscopy found stricture in bulbous urethra. Does this need urgent evaluation? 5 hours later
Feeling pressure while urinating and pain with irritations/burning sensations with pain in lower abd area in both sides. Means pedal edema may be due to stricture and you said that it gives inflammations effects too but how it will be treated. here doctors in Canada are just making time consuming, but symptoms as mentioned in previous questions, confused what to do. For edema now Cardiologist suggested Chronic Venous Insufficiency test in Right and Left legs, not done so far, even durin last one month both feet getting cold, pain in back pain increased day by day. On other hand 2 days back Neurologist suggested Physiotherapyfor pain left shoulder C6-5,C5-4,C4-3, you can suggest any further tests,
Answered by Dr. Prasad 15 hours later
Hi and thanks again,

I apologize if my previous answer was not clear. Let me try today.

1. Urethral stricture cause narrowing of the lumen resulting in obstruction of flow of urine. The symptoms one can have when there is a stricture are weak urinary stream, straining to urinate, a spread-out stream, hesitancy, incomplete emptying, urinary retention and post-urination dribbling. Frequent and painful urination are also common initial complaints. Severe obstruction may cause hydronephrosis, renal dysfunction, infection and so on.

Based on your description, I am unable to relate your symptoms to the urethral stricture alone.
a. Pedal edema and feeling cold can be related to cardiovascular pathology. As your cardiologist predicted, chronic venous insufficiency needs to be ruled out by doppler scans.
b. In the absence of hydronephrosis, back pain is not related to the stricture. Follow up with your neurologist for its management.

To answer you queries now:

1. In the absence of the aforementioned urinary complaints, presence of urethral stricture is a benign condition. However if it concerns you, you can get a few investigations such as ultrasound abdomen and retrograde urethrography (RUG) / voiding cystourethrography (VCUG) after discussing with a competent urologist. These tests will tell us more about the size and extent of stricture.

If significant, stricture can be corrected by surgical techniques.

3. Pedal edema and cold sensation in the peripheries may be related to venous insufficiency and can be ruled out be doppler scans. You can get the test done as planned.

4. Back pain and shoulder pain can be managed well with physiotherapy. In addition adequate rest, heat compresses and some mild analgesics will give you additional benefits. We can consider further testing like X-ray, CT / MRI scans if the pain worsens.

Hope this is clear now. Let me know if I have missed out any of your concerns.
If all your queries are answered, do accept the answer and close the discussion.

All the best

Above answer was peer-reviewed by
Follow-up: Hematuria, leg swelling, stiff body. Cystoscopy found stricture in bulbous urethra. Does this need urgent evaluation? 8 hours later
Dear Doctor XXXXXXX
CT scans reports are attached, you will see that in first CT scan they noted fibroid. does this is/can happen and is congenital ,
my family doctor also explained that this type can be possible from birth, does this is correct?
how come during addendum they remove this finding. Does those findings are related to stricture and hematuria.?

CT reports are very confusing, does CT scan shows any serious concerns and findings mentioning fibroid like is possible.Report 2 reads -"Amildly bulky uterus is noted with calcified fibroid"
you can please guide for this and also findings of CT scan which was done before intravenous and after then Addendum(Re study of CTscan)
Pain in lower abd area travels to back side may be due to these findings as mentioned in report 2 attached.
Answered by Dr. Prasad 19 hours later
Hi and thanks again,

Computed Tomography (CT) scans provided contain 2 reports. I was able to view them. The scan reports are as follows:

1. A normal report which I believe is of yours. Here there are no abnormalities noted to be causing the hematuria. There are no mentions about urethral stricture.

The scan reported is unremarkable and there is no reason to concern.

2. Along with this, there is a second scan which reveals bulky uterus with calcified fibroid. As uterus is not seen in men, this scan is NOT yours. Please check with the related authorities to verify about it.

This definitely is not the cause of your symptoms.

In simple words,
- As the first scan is unremarkable, you need not concern. However if you continue to have hematuria and urine persist to show dysmorphic red blood cells, discuss with a nephrologist about further testing such as a biopsy.

- Urethral stricture is probably benign issue, if it is not troubling you clinically. If it is bothering you, as discussed in my earlier reply, consider getting the test done by an urologist.

- The bulky uterus and fibroid is not your report.

Hope it is clear to you. If all your queries are answered, please close this discussion.

Wish you good health.

Best Regards
Above answer was peer-reviewed by
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