Urethrotomy

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Urethrotomy is a medical procedure used to treat urethral stricture, a condition where the urethra becomes narrowed, causing difficulty in urination. This procedure involves the surgical incision of the urethra to relieve the obstruction.

Indications

Urethrotomy is typically indicated for patients with:

• Recurrent urethral strictures
• Strictures that are not amenable to urethral dilation
• Strictures causing significant urinary symptoms or complications

Procedure

The procedure is usually performed under general anesthesia or spinal anesthesia. A specialized instrument called a urethrotome is inserted into the urethra. The urethrotome has a blade or laser at its tip, which is used to make an incision in the stricture, thereby widening the urethral passage.

Types of Urethrotomy

There are two main types of urethrotomy:

• **Cold knife urethrotomy**: Utilizes a cold knife to make the incision.
• **Laser urethrotomy**: Uses a laser to cut through the stricture.

Postoperative Care

After the procedure, a urinary catheter is usually placed to keep the urethra open and allow for healing. The catheter is typically left in place for a few days to a week. Patients are advised to drink plenty of fluids and may be prescribed antibiotics to prevent infection.

Complications

Potential complications of urethrotomy include:

• Recurrence of the stricture
• Urinary tract infection
• Bleeding
• Urinary incontinence
• Erectile dysfunction

Alternatives

Alternative treatments for urethral stricture include:

• Urethral dilation
• Urethroplasty
• Permanent urethral stent placement

Prognosis

The success rate of urethrotomy varies, with some patients experiencing long-term relief and others requiring additional procedures. The likelihood of recurrence depends on factors such as the length and location of the stricture, as well as the patient's overall health.

See Also

• Urology
• Urinary system
• Endoscopic surgery
• Urethra