Urethrotomy Surgery

Overview

Are you being plagued by symptoms such as pain during urination, urinary tract infections, blood in urine, and the inability to fully empty your bladder? You may have a urethral stricture, which is a narrowing of the urethra due to scarring from swelling, injury, or infection.

One of the ways in which urethral strictures can be treated is a surgery called urethrotomy. Let’s find out what happens during a urethrotomy, and how it can help you.

What Is A Urethrotomy?

A urethrotomy is a surgical procedure to open up a urethral stricture, which is the narrowing of the urethra, the tube that carries urine out of your body. A urethrotomy is also called a ‘direct vision internal urethrotomy’. 

The surgical procedure involves passing a urethrotome (a surgical instrument used to make an incision in the stricture) through a cystoscope (a long, thin, tube-like optical instrument with an eyepiece at one end and a lens and light at the other end) to widen the narrowed urethra. The surgeon then makes a cut in the scar tissue using the urethrotome to make the urethra wider and improve urine flow.

Among the many benefits of the surgery, a patient may experience improved urinary flow and bladder emptying, and fewer urinary tract infections (UTIs) after the surgery.

When Is A Urethrotomy Recommended?

A urethrotomy is recommended when a patient is diagnosed with a urethral stricture. A urethral stricture occurs when a part of the urethra becomes narrowed due to the formation of scar tissue. This scar tissue may be formed as a result of an injury, infection, or damage to the urethra.

A urethral stricture may cause symptoms such as a decrease in urinary flow, incomplete bladder emptying, the need for a long time to empty the bladder, increased frequency of passing urine, presence of blood in the urine (a condition called hematuria), and recurrent urinary tract infections.

If the doctor suspects that you may have a urethral stricture, they will run some tests to confirm the diagnosis of the condition. The diagnostic tests may include a physical examination, a urethral X-ray, urethral ultrasound, a urethroscopy (examination of the interior of the urethra using a camera-wielding probe called a urethroscope), and a cystoscopy. 

Once the diagnosis of urethral stricture is confirmed, the doctor may analyze all treatment options and recommend a urethrotomy.

How To Prepare For A Urethrotomy?

• Before scheduling the surgery, the doctor will hold a consultation to discuss the entire procedure and your expectations from the same. Use this consultation to discuss the benefits and risks of a urethrotomy, and get answers to any doubts you may have about the procedure.
• The doctor will also discuss your medical and surgical history and any medication and drugs you are currently taking. You may be asked to discontinue any medication that may increase bleeding risk during the procedure. 
• The doctor may order blood tests and an electrocardiogram to ensure you are healthy. They may also ask you to undergo imaging tests and perform a cystoscopy on you to check the length and severity of the urethral stricture. 
• A sample of your urine will be sent out to check for bacterial presence. 
• You would be asked not to eat for 6 to 8 hours before the urethrotomy. 
• You may be advised to carry along loose-fitting underwear to wear after the procedure. This is because a catheter is placed in your bladder to promote healing of the surgical site and to drain the bladder for several days after the procedure.?
• You will have to arrange for someone to drive you home after the procedure. 
• You will be asked to carefully read and sign the consent form for the procedure.

How Is A Urethrotomy Performed?

• You are asked to take antibiotics before the procedure to reduce the risk of infections.
• The surgeon will ask you to change into a hospital gown and lie on a cystoscopy table. You will be made to lie on your back with the thighs spread apart and the knees raised and pulled back.
• You will be given anesthesia. A urethrotomy is usually performed under general or spinal anesthesia. In some cases, local anesthesia may be used.
• The surgeon begins the procedure by inserting a cystoscope through the urethra into the bladder. The cystoscope has a light and camera at the end, which sends images to a monitor and helps the surgeon visualize the stricture that needs to be treated. 
• Now, the urethrotome is inserted through the cystoscope and positioned at the site of the stricture. 
• The sharp blade of the urethrotome is used to make an incision in the stricture and widen the urethral opening.
• At this stage, the surgeon reassesses the stricture and more incisions are made if it has not opened up sufficiently. 
• Next, the bladder is completely emptied of urine and filled with irrigation fluid, a solution that flushes and cleanses cavities and wounds.
• A catheter is placed in the bladder and used to drain the irrigation fluid. It may remain in place for up to a week to keep the space open and let it heal.
• Your urine may be blood-stained or you may leak some blood around the site where the catheter enters your urethra. This is normal and expected after the surgery.
• You are transferred to the recovery room to be monitored after the surgery. 

What Happens After A Urethrotomy?

• Your condition will be monitored in the recovery room, with your vitals and pain levels being checked regularly. 
• You may be allowed to go home on the day of the surgery if the surgical team clears you for it. 
• Expect some amount of discomfort, a burning sensation in the urethra, and strong urges to urinate after the surgery. 
• Before you go home, the surgeon will provide instructions on managing the catheter and prescribe antibiotics to reduce the chances of infection post-surgery. 
• In a few days after the surgery, you should be able to move around and return to work.

Are There Any Complications Associated With A Urethrotomy?

The most common complications associated with a urethrotomy include:

• Urethral pain
• Bleeding
• Infection
• Recurrence of urethral stricture
• Swelling of the penis
• Inability to pass urine
• Urinary incontinence

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!