What is a urethrotomy?

A urethrotomy is an operation to treat a narrowing of your urethra (tube that carries urine and semen to the tip of your penis). The narrowing (stricture) is usually caused by scar tissue forming after inflammation, an infection or injury.

A narrowing can happen anywhere along the length of your urethra. This results in the following symptoms.

• The need to pass urine more often.
• Sudden urges to pass urine.
• Having to wait longer than usual before starting to pass urine.
• Slow flow of urine, often with dribbling.
• The urine stream forking or spraying.
• The feeling of not having fully emptied your bladder.

What are the benefits of surgery?

You should get a better flow of urine and improved bladder emptying, and not need to pass urine as often during the night. You should also be less prone to infections.

Are there any alternatives to a urethrotomy?

It is possible to try to treat a narrowing using the following techniques.

• Balloon dilatation — This involves inflating a balloon in your urethra to make it wider.
• Dilators — This involves placing small metal rods, called sounds, into your urethra to stretch the narrowing.

More complicated narrowings sometimes need open surgery, where the narrowing is repaired using plastic-surgery techniques.

What does the operation involve?

The operation is performed under a general or spinal anaesthetic. The operation usually takes less than 30 minutes.

Your surgeon will pass a rigid telescope (cystoscope) into your urethra to examine the narrowing.

The urethrotome has a small blade, which your surgeon will use to make a cut in the scar tissue to make your urethra wider.

Your surgeon may then pass the cystoscope into your bladder to check for any problems.

Your surgeon may place a catheter (tube) in your bladder.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection
• allergic reaction to the equipment, materials or medication
• chest infection

Specific complications of this operation

• difficulty passing urine
• a swollen penis
• narrowing of another part of your urethra

Consequences of this procedure

• pain

How soon will I recover?

You should be able to go home the same day or the day after.

Do not do strenuous exercise during this time. You should be able to return to work after a few days.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Sometimes a narrowing can happen again and symptoms will come back.

Most men make a good recovery, with a large improvement in their symptoms.

Summary

A narrowing of your urethra can cause a slow flow of urine, often with dribbling, pain and infection. A urethrotomy should relieve your symptoms.

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