What is a Urethrotomy?

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What is an Urethrotomy?

Urethrotomy is an operation to open up a stricture (narrowing) in the urethra (water pipe). A stricture occurs when a part of the urethra becomes narrowed by ‘scar’ tissue.

What causes a urethral stricture?
• Injury
• Damage (previous catheterisation or instrumentation)
• Infection
• Congenital

Symptoms of a urethral stricture:
• Decrease in your urinary flow (weak stream)
• Longer time to empty your bladder
• Incomplete bladder emptying
• Frequency of passing urine
• Recurrent urinary tract infections
• Haematuria (blood in urine)

Investigations to diagnose a suspected stricture:
Flow rate – this involves passing urine into a special machine which measure the volume of urine and the time it takes to empty the bladder. A reduced flow rate can indicate a stricture.
Flexible cystoscopy – a thin telescope is passed into the urethra under a local anaesthetic and into the bladder to assess the urethra and diagnose a stricture.
Rigid Cystoscopy – a relatively large size telescope is passed into the urethra under a general anaesthetic to assess the urethra.

What happens during the operation?
An urethrotomy is performed under a general anaesthetic (you will be asleep throughout the operation) or spinal anaesthetic (you will be awake throughout the operation, however you will feel no
sensation or pain below the waist). A telescope will be passed into your urethra and a small cut will be made at the stricture to widen it. A catheter (tube) is then inserted into the urethra and into
your bladder to drain urine from your bladder and to allow the urethra to heal following the operation. You may notice that your urine is blood stained or you are leaking some blood around the site of the catheter  where it enters your urethra. This is quite normal following the operation and will eventually settle.

The catheter may remain in place for up to one week, however individual circumstances may differ. The catheter will be removed either by the District Nurse attached to your general practitioner’s surgery or by the Urology Nurse Specialist in clinic.

Benefits of the operation:
• Improved urinary flow (stronger stream)
• Improved bladder emptying
• Fewer urinary tract infections

However, the stricture may reoccur and a further operation may be required. If this happens you may need to be taught self dilatation (passing a catheter into the urethra yourself) to keep the urethra open and prevent the stricture from recurring in the future.

If self dilatation is recommend by your consultant you will be referred to the Urology Nurse Specialist to be taught this procedure.