Optical Urethrotomy

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.

  • Avoid constipation.

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.

Relatively Common

  • 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.

Occasional

  • Infection of the bladder needing antibiotics.

  • Delayed bleeding requiring removal of clots or further surgery.

Rare

  • Septicaemia.

  • Inability to open stricture and need for a temporary suprapubic catheter.