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QUESTION: Dr. Gelman:
What is the most common type of stricture as a result of Prostate Seed Implant?How soon after does it usually occur?Is Dilation the best treatment to start with? Is urinating like in a V one of the symptoms or something else?
Thank-You very much for providing this service, it is greatly appreciated!

ANSWER: Dear Mike,

Urethral strictures after prostate radiation can often occur in an area of the urethra called the "membranous urethra".  However, there can be narrowing in other areas.  I do NOT think the approach should be dilation as soon as a stricture is seen with a scope.  I believe that complete imaging should be performed (called a retrograde urethrogram AND a voiding cystourethrogram) by the Urologist who is also doing the evaluation with the scope.  Then, after the exact location and length of the stricture is determined, the patient should be advised of all options which depend on the findings.  I would direct you to the following link for more detailed information:

I would suggest you read all of the sub-sections.  Best of luck.

---------- FOLLOW-UP ----------

QUESTION: Thanks for your reply.
Is urinating in a V one of the symptoms or what are the symptoms?

In general, a change in the way urine exits with regard to the spray pattern is related to possible narrowing at the tip or a change in the flow rate (bladder not squeezing as well, or blockage from stricture).  When I see patients who have had prostate radiation, and I suspect a stricture as a complication of that treatment, I first perform a cystoscopy.  If there is any narrowing, that procedure will confirm a narrowing but not provide details such as the length.  If there is narrowing, I do my own imaging to define the stricture, and then discuss options.


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Joel Gelman, M.D.


Urethral Stricture Disease, Peyronie's Disease and disorders of penile curvature, Erectile Dysfunction with a focus on penile implant surgery, Male Incontinence, Hypospadias


Dr. Gelman is a Board Certified Fellowship Trained expert in Male Reconstructive Urology and the Director of the Center for Reconstructive Urology in the Department of Urology at UC, Irvine Medical Center.

American Urologic Association Society of GU Reconstructive Surgeons (Board of Directors) International Sexual Medicine Society Western Section, Americal Urological Association

Journal of Urology Urology Journal of Endourology

Residency in Urology, UCLA, completed 1995 Fellowship in GU Reconstruction, Devine Center, completed 1997

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The Center for Reconstructive Urology is a regional, national, and international Tertiary Referral Center for urethral stricture disease, penile curvature, erectile dysfunction, male incontinence, and other surgical disorders of the male urethra and penis. Patients have travelled from 24 different states and other countries to receive care at the Center for Reconstructive Urology. More information can be found at

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