Cairns Urology

A visual urethrotomy is a procedure carried out on the urethra of the male patient for treatment of a stricture. A stricture is a narrowing within the pipe (urethra), usually caused by scar tissue which reduces the ability of the man to pass urine.

Procedure

The procedure is usually carried out under general or regional anaesthesia. An endoscopic instrument is passed down the penis to the level of the stricture and often a guide is passed through the stricture and into the bladder to identify the correct path. A knife blade is then extended from the end of the instrument and a cut made in the stricture to enable the passage of instrument through that and subsequently into the bladder. The procedure may be carried out using intravenous antibiotics to reduce the risk of infection. There is usually very little bleeding. If the stricture is extremely narrow or lengthy, an indwelling catheter may be left in at the end of the procedure. Occasionally this is left in for a period of up to fourteen days to enable the healing of the urethra to occur around the catheter, while the catheter holds the tube open. See section on management of indwelling catheter.

Anaesthesia

This procedure is usually carried out under general anaesthetic. That is, the patient is completely asleep. Sometimes the procedure may be carried out under regional anaesthesia where the patient is given an injection into a vein to induce drowsiness and another injection is placed in the patient's back so that there is no feeling of pain below the waist. The patient may actually be awake for that type of anaesthetic.

Post Procedure

The operation will be discussed with the patient and the accompanying person in order that he may fully understand the situation. Arrangements will be made for follow up at that time. Follow-up may require re-admission to hospital for removal of the catheter and monitoring of urine output, which will be carried out by using an ultrasound scan of the bladder to estimate the remaining urine following each time it is passed. This is to ensure that the bladder is emptying completely and that a good result has been achieved.

Your GP

The referring doctor will receive a report within twenty-four hours of the procedure that has been undertaken.

Precautions & Guidelines

If any difficulty is experienced post-operatively with bleeding, pain or if the patient has a temperature of over 38°C then the patient should notify the doctor. Similarly, if there is difficulty with an indwelling catheter, notification should occur as often the solution to these problems is relatively simple and fears and worries can be allayed.