Urethrotomy

What is Urethrotomy

Urethrotomy is a surgery to treat a section of the urethra that is too narrow (urethral stricture). The urethra is the tube that moves urine from the bladder out through the tip of the penis. Urethral stricture makes it difficult or painful to pass urine, and it can increase your risk of having more frequent urinary tract infections (UTIs). The goal of surgery is to remove urethral stricture and restore the normal flow of urine.

Urethrotomy is performed by passing a thin tube with a light and tiny camera on the end (cystoscope) into the urethra. An instrument is used to cut a gap in any strictures and widen the urethra.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reactions to medicines or dyes.
  • Damage to other structures or organs.
  • Urethral stricture coming back after surgery.
  • Burning pain.
  • Inability to get or keep an erection (erectile dysfunction).
  • Needing more surgery to reconstruct the urethra (urethroplasty). This is sometimes needed if scar tissue forms after the urethrotomy.

What happens before the procedure?

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • You may be given antibiotic medicine to help prevent infection.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

General instructions

  • You may have a urine sample taken for testing.
  • You may be asked to shower with a germ-killing soap.
  • Plan to have someone take you home from the hospital or clinic.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • The tip of your penis will be cleaned with a germ-killing (antibacterial) solution.
  • An IV tube will be inserted into one of your veins to provide fluids and medicine.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to make you fall asleep (general anesthetic).
    • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • The cystoscope will be moved into your urethra.
  • A gap will be cut in the urethral strictures with a knife or a laser. This gap will allow urine to pass through the stricture.
  • A thin, flexible tube (catheter) may be inserted through your urethra and into your bladder to hold the gap open while it heals. The catheter will help drain your urine.
  • A bandage (dressing) may be placed over the tip of your penis.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • You will continue to have a catheter draining your urine. The catheter may be left in for a few days or weeks, depending on the size of the stricture.
    • You will be shown how to care for your catheter.
    • You may have some blood leaking from around the catheter when you pass urine.
  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • Do not drive for 24 hours if you were given a sedative.
  • You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.

Summary

  • Urethrotomy is a surgery to treat a section of the urethra that is too narrow (urethral stricture).
  • This procedure is performed by passing a thin tube with a light and tiny camera on the end (cystoscope) into the urethra. An instrument is used to cut a gap in any strictures and widen the urethra.
  • A thin, flexible tube (catheter) may be inserted through your urethra and into your bladder to hold the gap open while it heals. The catheter will help drain your urine.
  • The catheter may be left in for a few days or weeks after the procedure, depending on the size of the stricture.

Care After Urethrotomy

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

  • Burning pain when urinating.
  • Pain or discomfort around your penis.
  • A small amount of blood in your urine. Your health care provider will tell you how long you can expect to have blood in your urine.
  • Bloody urine leaking from around your catheter.

Follow these instructions at home:

Catheter care

  • Follow instructions from your health care provider about how to care for your catheter and your drainage bag.
  • Do not take baths, swim, or use a hot tub until your catheter has been removed. You may take showers while your catheter is in place.
  • If you have to do self-catheterization after your catheter is removed, make sure you understand the procedure completely. Carefully follow instructions from your health care provider.

Driving

  • Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
  • Do not drive or use heavy machinery while taking prescription pain medicine.

Activity

  • Take short walks several times a day during your recovery.
  • Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider tells you that this is safe.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Drink enough fluid to keep your urine clear or pale yellow.
  • To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
    • Take over-the-counter or prescription medicines.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
  • If a bandage (dressing) was applied to the tip of your penis, change the dressing as told by your health care provider. Make sure you:
    • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
    • Keep your dressing clean and dry.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever or chills.
  • You have pain that gets worse or does not get better with medicine.
  • You continue to have blood in your urine longer than your health care provider told you to expect.
  • You have trouble getting an erection.
  • You have pain when you have an erection.
  • You have blood in your semen.
  • You have any of the following problems after your catheter is removed:
    • Trouble urinating.
    • A slow urine stream.
    • Urinating less than usual.
    • Multiple streams or “spray” when you urinate.
  • You have pain in your abdomen.
  • You have swelling in your penis that does not go away.

Get help right away if:

  • You have severe pain.
  • You have a lot of blood leaking from around your catheter.
  • You have blood clots in your urine.
  • You cannot urinate after your catheter is removed.
  • You have chest pain.
  • You have trouble breathing.

Summary

  • After your procedure, it is common to have some pain during urination and a small amount of blood in your urine.
  • Follow instructions from your health care provider about how to care for your catheter and your drainage bag.
  • You should take short walks several times a day during your recovery.
  • If a bandage (dressing) was applied to the tip of your penis, change the dressing as told by your health care provider.
  • Contact your health care provider if you have trouble urinating after your catheter is removed.
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