Urethrotomy

Urethrotomy is a procedure for the treatment of the urethral stenosis. Stenosis is a scar inside the urethra that decreases its calibre. It can be due to several causes: congenital (usually detected in childhood), infections, trauma, or as a consequence of transurethral surgery prior to probing.
Carrying out this intervention requires local, regional or, in rare cases, general anaesthesia.

What does the endoscopic urethrotomy consist of?

It consists of the introduction through the urethra of an instrument, the urethrotome, which makes a cut in the urethral stricture or the fibrosis ring. A knife can be used (cold urethrotomy) or we can use the diode laser (laser urethrotomy). In this surgery, moderate blood loss occurs. After the operation, a bladder catheter is placed, which must remain for a period of 10 to 15 days.
The normal postoperative period is 1 or 2 days of hospitalisation. Once the urinary catheter is removed, you will begin to carry out normal urination, initially with small disorders (burning, urinary urgency, burning, stream in the form of rain, urinating with a little blood or clots and even a slight leak of urine) that will disappear in a few days.

Risks of urethrotomy:

Despite the proper selection of the technique and its correct performance, there may be undesirable effects, both the common ones derived from any intervention and that can affect other organs and systems, such as those derived from chronic diseases (diabetes, hypertension, heart disease, advanced age, obesity, etc.) as well as those of the procedure and which are:
– Uncontrollable haemorrhage, both in the surgery and in the postoperative period, which may require transfusion of blood products.
– Infection.
– Acute or chronic urine retention, which may require the replacement of a bladder catheter.
– Persistence of urination disorder despite surgical correction of the obstruction.
– Development of a urethral stricture that causes a new obstruction, which may require a
new surgical treatment.
– Urinary incontinence that can be: total and permanent, partial and permanent, total and transitory or partial and transitory.
– Liquid reabsorption syndrome, due to the inevitable absorption of irrigation fluid passing into the bloodstream. This syndrome can vary from mild intensity (blindness or transient blurred vision, hypotension…) at maximum severity causing kidney failure between other complications.

These complications are usually resolved with medical treatment (medications) but can
end up requiring a reoperation, usually urgent. No invasive procedure is totally free of major risks and complications.

The goal of the procedure is to improve the quality of urination and bladder catheter suppression if you use it.

You might also want to read: Kidney Stones Treatment