Page 2 - Urethral Strictures in Men

Urethral strictures in men
Dilation
Urethral dilation often can be performed in your
urologist’s office under local anesthetic (“freezing”).
This involves stretching the stricture using increasingly
larger dilators. If the stricture recurs rapidly, one can
be taught how to insert a catheter into the urethra
periodically to maintain the opening. Dilation alone
will often not completely cure the stricture. Pain,
bleeding and infection may occur after stricture
dilations.
Internal urethrotomy
Internal urethrotomy involves cutting into the scar
causing the stricture with a specialized cutting
tool or laser. This may be done in a clinic with local
anesthetic (freezing), or in the operating room under
a spinal or general anesthetic (you are “put to sleep”)
as necessary. Your doctor will incise your stricture
through a specially designed “scope” (cystoscope)
that can be passed into the urethra up to the stricture.
A catheter may be left in the urethra to allow it to
heal in an open position. This procedure can be very
useful for strictures at the bladder neck as well as in
the urethra. After the procedure there may be blood
in the urine and urethral bleeding with discomfort.
Occasionally, infection requires antibiotic treatment.
Unfortunately, the risk of stricture recurrence after
internal urethrotomy is significant.
Occasionally, after an internal urethrotomy, a
permanent stent can be placed across the stricture to
hold it open. A stent is a cylindrical metal mesh which
can expand to prevent the stricture from narrowing.
This treatment may be useful for select patients as
complications related to the stent may occur and
removal may be difficult.
This publication is produced by
The information in the publication is not intended to convey medical advice or to substitute for direct consultation with a qualified medical
practitioner. The Canadian Urological Association disclaims all liability and legal responsibility howsoever caused, including negligence, for the
information contained in or referenced by this brochure.
© 2014. Canadian Urological Association. All rights reserved.
Urethroplasty
A urethroplasty is a surgical procedure which is
performed through an incision to repair a stricture
of the posterior urethra, the anterior urethra or
the meatus. There are many different types of
urethroplasties. The choice of repair depends on the
location and length of the stricture.
Open urethroplasty of a short urethral stricture
may involve surgery to remove the stricture and
simply reconnect the two ends. When the stricture
is too long, the missing segment of urethra can be
reconstructed with tissue transferred from elsewhere
in the body. Different types of tissue can be used
including skin from surrounding areas or the lining of
the mouth (buccal mucosa). These repairs may be
challenging, and may need to be performed in stages
in some circumstances.
The open urethroplasty procedures are performed
through an incision in the crotch or in the penis. This
surgery, usually carried out under general anesthetic,
may be either an out-patient procedure or it may
require a short hospital stay. A small, soft catheter may
be left in the penis for up to three weeks to ensure
healing of the repair.
After treatment
Because urethral strictures can recur at any time, you
should be monitored by your doctor following surgical
repair. You may be asked to learn to self dilate
the area with a catheter tube to delay or prevent
recurrence. Periodic office appointments to review
voiding function and a test of your urine flow may be
necessary. X-rays or urethroscopy may be needed
to evaluate the repaired area. Some will require
additional surgical procedures over time to maintain
normal urination.
Urethral strictures are a common cause of voiding
problems. They often can be managed simply by
your physician with minor surgery.
cua.org
47E-USME-01-14