Table of ContentsView All
View All
Table of Contents
Purpose
Risks
Alternative Procedures
Before the Surgery
How to Prepare
Things to Bring Along
During the Surgery
In the Recovery Room
After the Surgery
Recovery
Possible Complications
Coping With Anxiety
Urethrotomy, also known as direct vision internal urethrotomy, is a surgical procedure used to treat urethralstricturedisease. It is an outpatient surgery that involves using a urethrotome or a surgical knife passed through acystoscopeto widen a narrowed urethra. Urethrotomies are generally only performed on men, as urethral strictures in women are very, very rare.
If you complain about symptoms likepain when urinating,urinary tract infections,blood in urine, spraying urine, and inability to fully empty your bladder, your healthcare provider may suspect that there’s a narrowing in your urethra (the tube that lets out urine from your bladder).
It’s only after this diagnosis has been made that your healthcare provider will recommend you undergo a urethrotomy.
The long-term success rate of urethrotomies is pretty low and many people who have one will still have to undergo subsequent surgeries as there is a high risk that the urethral stricture will reoccur. A medical study reports that in the short term (less than 6 months), success rates for urethrotomies are about 70–80 percent.However, after one year, this goes downwards and the rates of recurrence start to approach 50–60 percent. At the 5-year mark, recurrence shoots up to about 74–86 percent.
Urethrotomy is still medically regarded as asound optionfor treating urethral strictures, especially when open surgery (urethroplasty) would be an overtreatment, or as a management option before making the decision on whether open surgery should be had.
It is likely that your healthcare provider will order imaging tests and/or perform a cystoscopy in order to gauge the length and severity of the stricture. He may also order some blood tests to be done to check and ensure that you’re in a good state of health.
A sample of your urine will also be tested to ensure that there are no bacteria in it. Depending on your age and any pre-existing heart conditions you may have, your healthcare provider may order a heartelectrocardiogram(ECG).
You will discuss your medical history with your healthcare provider and you’ll also discuss how the surgery will be performed and its possible risks. You should expect to discuss all medication and drugs you’re currently taking with your healthcare provider because you may need to stop taking them some days or weeks before your urethrotomy.
Expect to sign a consent form, which you should read carefully. Also, make sure to ask questions about any section or part of the form you are unclear about.
If you have any medications you take daily, you should ask your healthcare provider how you should take them the day of your operation. The surgery generally takes about 30 minutes.
A urethrotomy is usually performed under general or spinal anesthesia. In special cases, local anesthesia may be used.You can expect the following:
While you’re in the recovery room, your condition will be monitored. You can expect a nurse to check the following at regular intervals:
You may be given an IV (intravenous) drip through which pain medication (often not needed) and fluids will be passed into your bloodstream. You may also be fitted with an oxygen mask to help you with breathing. Eventually, when you’re fully awake and comfortable, you’ll be moved to a ward pending your discharge.
Before, During, and After General Anesthesia
Most people go home the same day as the surgery, although depending on the circumstances, you may be asked to stay as an inpatient for a day. Because of the anesthesia involved, many hospitals require that you have another adult available to drive or accompany you home after the surgery.Residual effectsof the anesthesia make it advisable that you don’t drive or operate any heavy equipment for at least 24 hours after the procedure.
Before you leave, you should inform your healthcare provider/attending nurse about any pain or discomfort you may be feeling so that they can implement the most suitable pain relief system for you. You may experience some discomfort after the surgery and/or a burning sensation in your urethra, as well as strong urges to pee—this is normal.
The catheter put in place during the surgery will likely have to remain for some days.The primary purpose of this is to keep the space open and let it heal that way. In the meantime, you can expect the following:
There are certain complications that can occur after you undergo a urethrotomy. Some of the most common ones are:
Some otherwise uncommon and serious complications are:
If any of these three happen, you should immediately report it to your healthcare provider.
There are certain factors that increase the risk of complications post-surgery, and a major one is smoking. Smoking can negatively affect the wound-healing process.It may be helpful for you to begin nicotine replacement therapy before your surgery in order to reduce your risk of developing serious complications. In any case, if you smoke, you should definitely disclose it to your healthcare provider, who will then recommend the best course of action.
Other things that can increase your risk of complications are bleeding disorders and blood-thinning medications. If you have a blood clotting disorder or you are taking medication that deliberately or inadvertently (like aspirin) reduces your body’s blood clotting abilities, be sure to tell your healthcare provider.
During these follow-up visits, it’s important that you disclose concerns or any worrying phenomenon you may be experiencing to your healthcare provider.
The first thing you need to know is that it’s perfectly normal for you to feel anxious, worried, or even fearful about your upcoming surgery. Undergoing surgery is likely a completely new situation for you and it’s natural to require some emotional and practical support for it.
Fortunately, a urethrotomy is a simple, usually outpatient, surgery with minimal chances of serious complications. You’ll recover fast and be back on your feet in no time.
A Word From Verywell
Before you consent to have this surgery, or indeed, any other kind, you should discuss your options extensively with your healthcare provider. Feel free to seek a second medical opinion if you’re still unsure about what route to go. And lastly, try to have realistic expectations of the outcome of the surgery.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Agency for Healthcare Research and Quality.Blood thinner pills: your guide to using them safely.
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Urology Department, Waitemata District Health Board. Urethrotomy.
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