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In men, part of the urinary tract called the urethra, can occasionally become narrow, which is known as stricture. This can be due to things like scarring or injury and it can make flow of urine more difficult or even painful. One method to address this is a urethrotomy, or a surgical method for relieving stricture of the urethra.
Urethrotomy is a closed surgery instead of an open one, and it is one of several choices available to treat stricture. It may not be appropriate if narrowing or scar tissue is extreme, and when stricture is less challenging, surgeons might try other methods instead of urethrotomy, including inflating the urethra with a balloon to widen it, or placing a stent that keeps it open.
However, urethrotomy is the best choice for some patients. Doctors typically explain the surgery in detail to patients, but it can be simply described too. Point of entry for the surgery is the penis, and the surgeon will insert an inflexible device, that is usually attached to a camera or scope, in through the penis. This is known as a urethrotome, and it usually has a small cutting device attached to it. When the area of narrowing is reached, cuts are made so that the urethra will be larger in size. Urine catheterization is typically required during this surgery too, and men are likely to wake with this still in place. The cath is usually removed within a half day to a full day after surgery, and in many cases, men may go home the day of the surgery.
Urethrotomy isn’t a lengthy surgery but it can be painful and anesthesia is required. Most often, the surgery is performed under general anesthesia. Occasionally, surgeons may opt to give a nerve block like an epidural or other spinal block to numb all sensation. This may make this surgery an option for people who would not tolerate general anesthesia due to other health conditions.
After having this surgery, it can be uncomfortable to urinate for a few days, and urinating can cause a burning sensation. This tends to get better fairly quickly, and many men note marked improved in urinary flow especially after initial recovery. There are some complications to urethrotomy, and these could include creating stricture elsewhere in the penis, causing holes to form in the bladder, or more generally too much post-operative bleeding or infection. Sometimes urethrotomy is not sufficient to correct stricture, and in this case, surgeons may need to opt for an open surgical procedure to correct the problem, which is called a urethroplasty.