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Optical Urethrotomy

Cut/Incise scar tissue in urethra

This procedure is done to cut or incise scar tissue that has developed in your urethra. 
This occurs for several reasons:

  • It can result from having a catheter or from a previous procedure involving a telescope down your urethra.

  • It can be a result of pelvic trauma e.g. pelvic fracture.

  • Often there is no apparent reason for the stricture developing.

 A urethral stricture will cause trouble with your flow. The flow is often poor, and you often develop urinary frequency and feel like you are not emptying your bladder. This can lead to trouble with recurrent urinary infections, inability to pass urine at all (urinary retention), and even bladder stones.

Procedure

The surgery is usually done under general anaesthetic. A camera is inserted into the urethra, and then a special type of blade (or occasionally a laser) is used to cut the stricture. This creates the effect of opening up the urethra, which reduces the resistance to urinary flow. The procedure does not normally take very long, and you will often be in the recovery room within 30 min. Usually, a urinary catheter is placed while you are still asleep. This can be left in for a variable amount of time, depending on the severity of the stricture. You are often able to go home the same day, but if necessary a one-night stay in the hospital is all that is required.

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Post Procedure and Complications

Once the catheter is removed, and you have passed good volumes of urine you are able to go home. Occasionally we send you home with a catheter as there has been extensive scar tissue present. The catheter may then be in as long as 5 to 7 days. There is a small risk of urinary infection after the procedure, and occasionally we will send you home on antibiotics.

It is not unusual for you to have an increasing sensation of needing to pass urine (frequency and urgency) or see some blood in the urine. 

Return to Work

This depends on what is found at surgery. If the stricture is minor, and your catheter is only in overnight, you could be back at work within a week. If there is more extensive scarring, and the catheter stays in place for 5-7 days, then you may need 2 weeks off work. 

​Follow up

It is important that we continue to follow you up after your procedure, as there is a significant chance that the stricture will recur. If this happens we would normally contemplate a urethroplasty, which is a procedure where the scar tissue is removed via an incision in the perineum. 

We will see you at Bay Urology 6 weeks after your surgery with a flow test.

Normally we would continue to follow up for at least a year after surgery.