What is it?
This is a procedure that opens a stricture (scarred segment) of the urethra – the tube through which you pass urine.
Who needs an optical urethrotomy?
Men who are having difficulty passing urine, with a slow often spraying stream caused by a stricture are candidates for an optical urethrotomy.
What does the procedure involve?
A cystoscope (telescope for looking at the urethra and bladder) is passed into the urethra to visualize the strictured area. If the stricture is very tight a guidewire may be passed to the bladder for the surgeon to follow when opening up the narrowed length of urethra.
An optical urethrotomy is usually performed under a “light” general anaesthetic, though, on occasions, a spinal anaesthetic may be used. The anaesthetist will discuss the best option for you prior to the procedure.
The procedure is generally performed as a day procedure, though it is sometimes necessary for you to remain in hospital overnight. If the stricture has been particularly tight, you may be discharged with an indwelling catheter for a few days. If so you will be given a date to return to the surgery for removal.
What should I expect after going home?
For a few days after your procedure, it is normal to experience any of the following:
A mild burning when you pass your urine.
A need to pass urine more frequently, and occasionally more urgently than you usually do.
Some blood in the urine.
All usually settle quite rapidly without the need for any treatment
What can I do to help?
Drink plenty of water.
Take Ural or Citravescent in a glass of water 4 times a day.
Take 2 Panadol every 4 hours.
Take any antibiotics you have been prescribed.
Are there any possible side effects?
Most procedures are straightforward; however as with any surgical procedure there is a chance of side effects or complications.
Mild burning or bleeding on passing urine for a short period after the operation.
Need for intermittent self-catheterisation regime to keep the narrowing from closing down again.
Recurrence of the stricture needing further procedures or repeat incision – it is estimated this may be up to 30% of men will need a second urethrotomy.
Infection of the bladder needing antibiotics.
Delayed bleeding requiring removal of clots or further surgery.
Inability to open stricture and need for a temporary suprapubic catheter.