Urethral Stricture Treatment — including Optilume — in Buckinghamshire & the Thames Valley
Reviewed by Mr Neil Haldar – August 2026
What is a urethral stricture?
A urethral stricture is a narrowing of the urethra — the tube that carries urine out of the body — caused by scar tissue. As the channel narrows, urine flow is restricted, which can cause troublesome symptoms and, over time, affect the bladder and kidneys. Strictures are far more common in men and tend to recur, so choosing a durable treatment matters.
What are the symptoms of a urethral stricture?
The commonest symptoms are a weak or slow urinary stream, straining or pushing, a spraying or split stream, a feeling of incomplete emptying, and needing to pass urine more often. Some men develop urinary infections, and in more severe cases the bladder can stop emptying altogether — being unable to pass urine is a medical emergency needing same-day care. Because these symptoms overlap with an enlarged prostate, a proper assessment is important to identify the true cause.
What causes a urethral stricture?
Strictures often follow previous catheterisation, a telescope procedure or other instrumentation, an infection, or an injury — though sometimes no clear cause is found. Identifying the likely cause, the stricture’s position, and its length guides the right treatment.
How is a urethral stricture diagnosed?
Assessment usually combines a urine flow test and a measurement of how well the bladder empties, a flexible telescope examination of the urethra (flexible cystoscopy), and sometimes a specialised X-ray of the urethra (urethrogram) to map the exact site and length of the narrowing. This detail determines which treatment is most likely to give a lasting result.
What are the treatment options?
Treatment depends on the length, position and number of previous treatments:
- Urethral dilation — gentle stretching of the narrowed segment. Straightforward, but strictures commonly recur.
- Optical urethrotomy (DVIU) — the scar is incised under direct vision through a telescope. Effective for short, first-time strictures, with lower success when strictures recur.
- Optilume drug-coated balloon — a newer, minimally invasive option I offer (see below).
- Urethroplasty — open surgical reconstruction, the most durable option for longer or complex strictures. I don’t perform urethroplasty myself; where it is the right answer for you, I refer you to a specialist reconstructive urologist.
Optilume — a minimally invasive option
For men with recurrent short narrowings of the front part of the urethra, Optilume offers an alternative to repeated dilation or urethrotomy without moving straight to open surgery. It is a balloon that both dilates the narrowed segment and delivers medication to the urethral wall to help keep it open and reduce scarring that can cause strictures to recur.
In a randomised trial (ROBUST III), significantly more men treated with Optilume remained free from repeat treatment at two years than those who had standard dilation, with lasting improvements in flow and symptoms; side effects were uncommon and usually settled on their own. It is a day-case procedure, and I am one of relatively few urologists in the UK currently offering it. Optilume suits particular strictures rather than all of them, so we assess suitability individually.
Why see Mr Neil Haldar?
You get a rapid private assessment that pins down the true cause of your symptoms, a clear explanation of every option from dilation through to Optilume, and access to a treatment few centres provide — all from a Consultant Urological Surgeon with clinics across Buckinghamshire and the Thames Valley. Where open reconstruction is the better answer, I make sure you reach the right specialist.
How quickly can I be seen?
A private consultation can usually be arranged within a few days, with any imaging organised promptly.
Serving patients across Buckinghamshire, Berkshire, Oxfordshire, West Hertfordshire and London
My clinics are easily accessible from across the Thames Valley, serving patients in London, Buckinghamshire, Berkshire, Oxfordshire and the surrounding counties. Private consultations can usually be arranged within a few days.
I regularly see patients from:
- Buckinghamshire (Amersham, Beaconsfield, Marlow, Gerrards Cross, Denham, High Wycombe, Aylesbury)
- Berkshire (Windsor, Maidenhead, Ascot, Slough)
- Oxfordshire (Henley, Watlington, Thame, Chinnor)
- West Hertfordshire (Tring, Chesham, Berkhamsted, Rickmansworth, Chorleywood, Hemel Hempstead)
- North West London and the surrounding areas
Clinic Locations
I see private patients at Chiltern Hospital in Great Missenden, Shelburne Hospital in High Wycombe, Beaconsfield Clinic, Clementine Churchill Hospital in Harrow, and GenesisCare Windsor. NHS patients are seen at Buckinghamshire Healthcare NHS Trust via GP referral.
I am recognised by all major private health insurers, including Bupa, AXA Health, Aviva, Cigna, Vitality Health and WPA. If you have private medical insurance, please contact your insurer to obtain an authorisation number before your consultation.
Further Reading
BAUS urethral stricture information leaflet
