Urethral stricture in men can be treated with a urethrotomy, a surgical method that involves making cuts to enlarge the urethra. It may not be appropriate for extreme cases, and other methods like balloon inflation or stent placement may be used instead. The surgery requires anesthesia and catheterization, and discomfort during urination may occur afterwards. Complications include bleeding, infection, and the need for further surgery.
In men, a part of the urinary tract called the urethra may occasionally narrow, which is known as stricture. This can be due to things like scarring or injury, and can make urine flow more difficult or even painful. One method of dealing with this problem is a urethrotomy, or a surgical method to relieve urethral stricture.
A urethrotomy is a closed rather than an open surgery and is one of several choices available for treating stricture. It may not be appropriate if the narrowing or scar tissue is extreme, and when the stricture is less challenging, surgeons may try other methods instead of urethrotomy, including inflating the urethra with a balloon to widen it or placing a stent that keep it open.
However, urethrotomy is the best choice for some patients. Doctors typically explain the surgery in detail to patients, but it can also be simply described. The entry point for the surgery is the penis and the surgeon will insert an inflexible device, which is usually attached to a camera or scope, through the penis. This is known as a urethrotome and usually has a small cutting device attached to it. When the narrowing area is reached, cuts are made so that the urethra is larger in size. Urine catheterization is also typically required during this surgery, and men are likely to wake up with this still going on. The catheterization is usually removed half a day to a full day after surgery, and in many cases, men are able to go home the day of surgery.
A urethrotomy is not a long surgery but it can be painful and anesthesia is required. Most often, the surgery is performed under general anesthesia. Occasionally, surgeons may choose to give a nerve block such as an epidural block or other spinal block to numb all sensation. This may make this surgery an option for people who would not tolerate general anesthesia due to other health conditions.
After this surgery, it may be uncomfortable to urinate for a few days, and urinating can cause a burning sensation. This tends to improve quite quickly, and many men notice a marked improvement in urine flow, especially after initial recovery. There are some complications to urethrotomy and these could include the creation of strictures in other parts of the penis, causing holes to form in the bladder or more generally excessive postoperative bleeding or infection. Sometimes a urethrotomy isn’t enough to correct the stricture, and in this case, surgeons may need to opt for an open surgical procedure to correct the problem, called a urethroplasty.
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