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Glamorgan Urology: Urethra Restriction

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Urethra Restriction

Urethral Stricture / Urethrotomy

Urine passes out of the body from the bladder via the urethra. Occasionally the urethra may become scarred in one part of the tube forming a stricture. The stricture in the urethra may be caused by an untreated infection, scar tissue, surgery or even a trauma to the penis. This stricture may impede the flow of urine leading to more frequent urination and the possibility of repeated urinary tract infections.

Treatment

A urethrotomy is a procedure that is carried out under a general anaesthetic to correct this stricture, where the urethra is narrowed which causing problems with the flow of urine.

The urethrotomy corrects the urethral stricture using a rigid endoscope with a fine instrument passed up through the urethra to the narrowed area. The stricture is gently slit open to allow the widening of the urethra. A catheter is inserted into the urethra to allow urine to drain from the bladder for a few days during healing of the uretha.

Common Questions

What is a urethrotomy?

A urethrotomy is an operation performed for a stricture, when the urehtra (waterpipe) becomes narrowed causing problems with the flow of urine. This is usually caused by scar tissue formation, but sometimes the cause of this is unknown. Previous surgery, infections or trauma may cause the sticture to occur.

What happens during the operation?

The operation is carried out under general anaesthetic. A telescope is passed up the urethra, which allows the surgeon to see the stricture. A small cut is then made in the narrowed area of the urethra to widen it. The operation itself usually takes 10-20 minutes.

What happens after the operation?

You will be taken from the theatre to the recovery room, where you will be closely monitored until you are awake enough to return to the ward. You will usually have a catheter (tube) inserted into the bladder to drain your urine and to help the urethra to heal.

The catheter usually stays in place for 24-48 hours.

Once your catheter is removed, you can usually go home that day, so long as you are able to pass urine freely.

How will I feel when I go home?

It may be uncomfortable to pass urine for two to three days after you have been discharged from hospital. If your symptoms last longer than a week or you are worried about any thing else then you should seek advice from your GP. If at any time you cannot pass urine at all or start passing heavy blood clots you should call out your GP or go to your local A&E department.

Will I have full control of my urine?

Following removal of the catheter, it is usual to feel the need to pass urine more often than usual following your operation. This will settle down with time, once you start to heal. It takes time for the wound inside to heal and you may still experience symptoms until the wound has fully healed.

It may be necessary to repeat the operation in the future if there is any scarring or if the stricture reappears.

If this happens you may also need to be taught self-dilatation to keep the stricture from recurring. This is where you pass a fine catheter into your urethra twice a week then, once a week, then once a month. The urology nurse specialist will teach you this approximately one week after your discharge.

How much shall I drink?

You should drink up to two litres per day for the first week, as this will help to wash away the blood and helps prevent infection. After this, you should continue to drink fluid, as you would usually do. You may drink alcohol when you return home (in moderation).

What about follow-up by the hospital?

You will be sent an outpatient appointment to see your consultant six weeks to three months following discharge.

What are the risk from complications?

All operations carry the risk of complications. However, general anaesthetics are very safe these days and you will have the opportunity to discuss these risks and complications with the anaesthetist prior to your operation. Any form of surgery carries the risk of you developing a chest infection, a clot in your lung or leg, bleeding during or after surgery, or developing cardiac problems. Your doctor will discuss all risks and complications with you when you attend the pre admission clinic.

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