Urethrotomy Treatment

What is Urethrotomy?

Urethrotomy is a surgical procedure used for treating urethral stricture disease. It is an ambulatory surgery that involves the usage of a urethrotome or a surgical knife passed through a cystoscope for widening the narrowed urethra. Urethrotomy is usually done only on the men, as urethral strictures in the women are quite rare. A urethrotomy is an operation which involves cuts on the urethra, especially for relieving the stricture. It is generally done in the outpatient setting, with the patient being discharged from the hospital within six hours from the procedure's inception.

Why Urethrotomy is required?

If a person complains about symptoms like pain when urinating, blood in urine, urinary tract infections, and inability to fully empty their bladder, the doctor may suspect that there’s a narrowing in the person’s urethra. The next step will be to confirm if the person has urethral stricture disease or not. Urethral stricture disease can be diagnosed with the help of:

• Simple physical examination
• Urethral X-ray or ultrasound
• Retrograde urethrogram
• Urethroscopy
• Cystoscopy

It is only after this diagnosis has been made that the doctor will suggest the patients undergo a urethrotomy.

Symptoms leading to Urethrotomy Operation Treatment

Urethrotomy is a surgical operation often used to treat conditions that cause stricture of the urethra resulting from scar tissue formation. Symptoms that might lead to urethrotomy include:

• Decreased Urine Flow
• Difficulty Starting Urination
• Incomplete Bladder Emptying
• Frequent Urination
• Pain and Discomfort
• Recurrent UTIs
• Urinary Retention
• Bladder Stones
• Blood in Urine

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What are the risks involved?

The long-term success rate of urethrotomy is very low and many patients who have undergone the surgery will still have to undergo subsequent surgeries as there is a huge risk that the urethral stricture will reoccur after the passage of time.

There are certain complications that can occur after the patients have undergone a urethrotomy. Some of the most common ones are as follows:

Urethral pain: It is normal to feel a burning sensation or discomfort when the patients are urinating for a few days post-surgery.

Bleeding: It is normal that the patients will pass out a bit of blood with their urine. This condition should resolve itself within a week or so after their surgery has been concluded. If this condition persists or the patients start to see clots, they must report it to their doctor.

Infection: If the patients suspect they have a urinary tract infection after their surgery, they must immediately report it to their doctor.

Recurrence of stricture: There is a huge possibility that an individual’s urethra will narrow or a stricture will be developed again.

Various factors that may increase the risk of complications include the following:

•  Bleeding disorders or taking medications that reduce the blood clotting
• Obesity
• Smoking

Causes leading to Urethrotomy Operation Treatment

An urethrotomy is usually done to correct urethral strictures: a situation where the urethra is constricted by scar tissue. The causes leading to the development of urethral strictures, and subsequently an urethrotomy, include:

• Trauma or Injury
• Infections
• Inflammatory or Autoimmune Conditions
• Congenital Factors
• Medical or Surgical Procedures

Facilities and Services offered for International Patients for Treatment for Urethral Stricture

When it comes to international patients the options for getting urethrotomy, most of the medical centres offer the total care services that are necessary during the procedure. These services typically include:

• Pre-Arrival Support
• Language and Communication
• Travel and Accommodation
• Medical Services
• Rehabilitation and Follow-up

What to Expect from the Surgery?

Prior to Procedure:

The patient’s doctor may perform the following:

• The doctor will conduct a physical exam and ask the patients about their medical history.
• Order imaging, urine, and blood tests..
• The doctors talk about the anesthesia which is to be used and its potential risks.
• The patients must talk to their doctor about their medications. The patients may be asked to stop taking some medications up to 10 days prior to their surgery.

In the days leading up to the surgery:

• The patients must take a shower before the surgery as directed by the doctors.
• The patients must arrange a ride for their home from the hospital.
• The patients must not take anything by mouth starting 8 hours prior to their surgery. The patients must ask the doctor how they should take their regular medications on the morning of their surgery.

Anesthesia

• Spinal or general anesthesia will be used. It will use in blocking any pain and keep the patients sedated or asleep during the surgery.

Diagnostic Tests for Treatment for Urethral Stricture

Diagnostic tests for urethrotomy are intended to detect, determine the location and severity of the urethral stricture. Common diagnostic methods include:

• Uroflowmetry
• Ultrasound
• Retrograde Urethrogram
• Cystoscopy
• MRI or CT Urethrography

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Urethrotomy Surgery Procedure

• After the patients are asleep, a special tube known as cystoscope will be placed in the patient’s urethra for locating the stricture. 
• Next, a special tool will be placed through the cystoscope and will be used for cutting away the scar tissue inside the patient’s urethra for making it wider. 
• The scar tissue may be removed either by cutting or by the use of a heat source or a laser. 
• After the tissues are being removed, the bladder area and urethra will be examined. 
• A catheter (it is a plastic tube placed through the urethra into the bladder) may be placed once the procedure is being completed.

Post-Treatment Process of Urethrotomy

Below are various things that patients should expect to go through after they have undergone an urethrotomy.

• Immediate Post-Operative Care
• Monitoring and Follow-up
• Recovery Phase
• Long-Term Management
• Recognizing Complications

How long will the surgery take place?

The surgery usually requires about 30 minutes. Anesthesia prevents pain during the procedure. The patients must ask their doctor about medication, which helps them with their pain. The patients will be able to go home the same day in almost every case.

Alternate Options for the Urethrotomy:

Alternative procedures to a urethrotomy are urethroplasty and dilation. Dilation involves the insertion of thin rods for increasing the size into the patient’s urethra for stretching out the stricture and widening the narrowing. Urethroplasty is the replacement or reconstruction of a narrowed urethra by the means of open surgery. What the doctor will suggest the patients undergo largely depends on the severity of their urethral stricture and also on the success.

How soon will I recover?

The catheter will be put in place during the surgery and is more likely to remain for some days. The primary purpose of the catheter is to keep the space open and let it heal. In the meantime, the patients can expect:

• The doctor will tell the patients on self-catheterization or how to manage the one that has been already placed. The patient’s doctor will also tell them when to return to the hospital for removing.
• The patient’s doctor may also prescribe antibiotics for their post-operation for reducing their chances of getting an infection. The patients should maintain good hygiene for reducing the risks.
• The patients will be able to move around and are more likely to return to their work after some days.
• The patients must refrain themselves from sexual intercourse for a couple of weeks after the surgery has been performed. The doctors will tell the patients how long they must refrain themselves from any sexual intercourse.
• The patients must avoid intense exercise and strenuous activity until their doctor has given them the go-ahead.
• It is vital that the patients must not strain during bowel movements.

Success Rate of Internal Urethrotomy Treatment

Success of Urethrotomy depends on the location of stricture, the length of the structure and some characteristics of the patient. The technical success rate at first intervention varies between 70–90%, further collective efficiency and re-occurrence bear the greatest influence on final prognoses. Success rate is inversely proportional to the number of times it has been done as the success in relevance techniques diminish with every other urethrotomies.

Best Hospitals for Urethrotomy

• Artemis Hospital, Gurgaon
• Medanta The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• BLK-Max Super Speciality Hospital, New Delhi

Best Doctors for Urethrotomy

• Dr. Abhinandan Mukhopadhyay
• Dr. Rajesh Ahlawat
• Dr. Pradeep Bansal
• Dr. Anupam Bhargava
• Dr. H. S. Bhatyal

Why Choose GetWellGo for Urethral Stricture Disease?

GetWellGo presents numerous services to the foreign patients, who need urethrotomy and other treatments in India.

Here's why it stands out:

• Expert Medical Team
• Personalized Assistance
• Cost Efficiency
• Comprehensive Support
• Cultural and Language Support
• Travel and Accommodation
• Visa Assistance

Conclusion

Urethrotomy is an endoscopic procedure for urethral strictures which is effective in relieving the symptoms early, but long-term effectiveness is different: the rate of recurrence within the first year fluctuates between 30 and 50%. Follow up after the procedure, along with carrying out the dilation process on your own are also very important. In those few cases where external penile support is a problem, urethroplasty may be a more definitive solution.

FAQ

1. What are the advantages of urethrotomy?

• Minimally invasive: No big cuts or incisions that will take a long time to heal.
• Quick symptom relief: Helps to restore the flow of the urine and reduces urinary pain.
• Outpatient procedure: The majority of the patients are discharged and go home on the same day.
• Repeatable: May be carried out more than once, however the probabilities of such increase with the number of such procedures.

2. What are the success rates of urethrotomy?

• Short-term success: Initially, it is highly successful with the range of 70-90%.
• Long-term success: Recurrent stricture is estimated to be between 30-50% within one year of the initial intervention, depending on the length and location of the stricture.

3. What is the recovery period?

• Immediate recovery: Many of them can return to work soon, or at least perform low-stress tasks during the subsequent week.
• Full recovery: Is usually attained in about 2-4 weeks. Thus, one should not lift heavy objects or exercise any other activity that requires the usage of his or her back during this time.
• Sometimes a catheter may be necessary for about a week-two up to allow the wound to heal.