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What is Urethral Dilation?

By A. Ribken
Updated Mar 03, 2024
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Urethral dilation is a medical procedure in which the urethra is gently stretched with a rubber or metal tube. An abnormal narrowing of the urethra, called a stricture, may inhibit the flow of urine and cause serious health problems, making this procedure necessary. Though urethral dilation is normally performed by a urologist, with proper training and precautions, it can also be performed by a patient.

Conditions Requiring Treatment

This procedure is used to treat urethral strictures. These can be caused by scarring from an injury, repeated bacterial infections like urethritis, a history of Sexually Transmitted Diseases (STDs), or trauma from the insertion of an instrument such as a cystoscope or catheter. Rarely, strictures are also caused by birth defects or tumors. Symptoms of this condition include difficult or painful urination, pelvic pain, and blood in semen or urine. Patients who cannot urinate due to an extremely severe stricture must seek medical attention immediately, since they could be at risk for a bladder or kidney infection or injury, as the pool or urine may become infected, or abscesses may develop.

Those with frequent urinary tract infections may also require occasional treatments. Having repeated infections may be a sign of an unusually narrow urethra. Dilation often helps lower the frequency of these ailments because the bacteria causing them cannot build up as easily in a widened urinary passage.

Procedure

Medical professionals usually perform urethral dilation in stages. After the patient is prepped with anesthesia, a smooth metal tube is lubricated and carefully slipped into the urethra. The urologist then repeats the process with incrementally larger sizes of tubes until he or she determines that the urethra is wide enough to easily urinate. This procedure has about a 50% success rate for first-time performances. Some people need annual or semi-annual treatments to ensure even and painless urination.

Since urinary dilation is not guaranteed to succeed, can lead to discomfort and painful urination afterwards, and can lead to scarring if done incorrectly, some people seek alternative treatments. One of the most common ones is muscle relaxants to release the muscles controlling urination. If urethral dilation is ineffective due to severe pre-existing scarring, surgery may be needed.

At Home Treatment

With proper training, a patient can perform urethral dilation at home with different sized catheters. The benefits of doing this include immediate attention to the problem and increased comfort and privacy. The procedure typically involves gently cleaning the genitals with a soapy washcloth or disinfectant wipe and then slipping a lubricated catheter into the urethra. Patients should move very slowly and never shove or force the catheter. Self-dilation may drain the bladder; many patients prefer to do this in the bathroom for this reason.

Precautions

People who self-dilate should be trained by a medical professional to avoid accidentally tearing the urethra or causing an infection. Doctors may also prescribe a course of antibiotics to reduce risk of infection. All adverse symptoms that occur during self-treatment should be reported to a health care provider immediately. This includes pain during dilation, painful urination afterwards, or blood in the urine.

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Discussion Comments
By anon992460 — On Sep 09, 2015

Dear Anon, your father can do this easily at home. Ask the doctor; he can explain. Many people do it.

By anon990791 — On May 10, 2015

I self dilate with self catheters two or three times daily with non Foley caths which are ch16 and also carry a coloplast speedicath with attached bags when out and about to drain the remainder of my bladder. All this because I have nerve damage in my back after breaking it 20 odd years ago and a stricture in my urethra.

The doc started me with metal dilators in the hospital and eventually stretched me from about 1-2mm up to 10mm. I do this procedure every few months now myself to stay open, but the isc caths are there to stop me closing completely.

It has become part of my daily routine and my whole family knows I have to do it and supports me. I had the option of surgery but I don't fancy it and for all the time it takes me to do the procedure. There is no pain or blood unless I forget to dilate every few months and need to re-stretch again. --Trev

By anon989385 — On Mar 04, 2015

I have to do intermittent self catheterisation one or twice a week on a permanent basis using a non balloon (not a foley catheter) they come in boxes of 30 in sealed systems including sterile water. if I don't do this my constriction will close off and it becomes difficult to pass water and I have retention. and then want to pee all the time.

By anon951457 — On May 15, 2014

I am 51 and had this procedure done anywhere between three to six months apart. No fun but very frustrating when your stream is not strong enough to urinate normally

By anon945005 — On Apr 10, 2014

I am a male aged 73. I had a urethral dilation in April 2014. It included a urethrotomy. This was to address a bulbar stricture. The stricture is thought to have been caused by brachytherapy administered in 2008 to deal with prostate cancer. It was the second dilation, the first being carried out in 2010, but without urethrotomy.

In the recovery room following the procedure, I experienced discomfort, along with a strong desire to urinate despite a catheter being put in place.

Eventually the catheter was removed which was painful but gave me great relief.

It appears that tiny fragments of flesh produced by the urethrotomy had blocked the entry to the catheter and prevented it from draining.

Urinating the day after and at the time of writing caused stinging pain but is improving. I now face a regime of self-catheterisation three times per week to prevent the recurrence of the stricture. This will be a whole new experience.

By anon925666 — On Jan 13, 2014

Can a man dialate his shaft to the point he could take a dildo in the front?

By anon924823 — On Jan 07, 2014

I'm wondering if there could be a genetic link to developing urethral strictures. So far in my research, I've not found much in the way of studies correlating this, but I have a hunch.

This is an uncommon condition as it is, but in females it is especially rare. Considering this, I find it very odd that five women on my mother's side of the family have had this before and I've just been diagnosed at 25 years old and am otherwise completely healthy.

None of the cases in my family were congenital. In fact, all of them were well into adulthood at onset. They have all been diagnosed as having idiopathic causes (i.e., no bacterial or viral infections.) Also, none of them have needed re-dilation and it's been over 10 years since the last one had it performed. From my reading, that seems rare in and of itself.

In my admittedly vaguely-informed opinion, I'm starting to think that perhaps there could be different sub-types of this disease. Then again, it could just be dependent upon the cause and severity. All of this just seems very peculiar to me.

My doctor has advised that I try medications first before getting a dilation done and I have to agree with him on this one. It seems like a last resort when other methods have failed because it can, ironically, cause even more scarring, thereby further hindering proper function and almost always needs to be performed frequently.

I'm not saying it's a bad thing to get a dilation done; it's often necessary, but if you have the option and your doctor is willing, see if you can try other methods first. Sometimes an anti-inflammatory drug or antibiotic can reduce the swelling enough to do the trick.

By anon348826 — On Sep 20, 2013

I had a urethral dilation on Tuesday and given some new medicine for urine frequency. Today I urinated blood. I started drinking water and after an hour the urine was clear. Could this have been from the dilation? I thought it was from the medicine, but the nurse said the medicine wouldn't cause this.

By anon319650 — On Feb 14, 2013

@Ambrish: Your Father's case is exactly like my maternal uncle's (aged 42 years). It would be really great if some expert advisers can share their thoughts on it to have a permanent solution for this problem.

By anon260452 — On Apr 11, 2012

My mother is 72. About a week ago, she had the dilation done, and they just removed the urine pipe but then my mother was not able to start urinating regularly. What is the solution?

By mandydances — On Apr 29, 2011

@anon131658- I had a urethral dilatation as a child. Fortunately, I have not had any more problems. My doctor said that scar tissue could form from the procedure and close the opening again, leading to another surgery. In my case, this never happened.

However, it sounds like this is the case with your father. Sometimes tissue grows back and they have to do the surgery again. From what I read, there really is nothing else they can do at this point in time. Maybe in the future they will come up with something that does not require surgery.

By anon131658 — On Dec 03, 2010

I am from India. My father (age 61) underwent an operation as his urine passage was narrow and urine passing takes around 10 minutes. Doctors advised for operation wherein they will broaden the passage. It was done and thereafter urine passed in few minutes (hardly one or two). But thereafter every month or every 15 days we have to go in order for dilation (which is a 5 minute work for doctor).

But there is no permanent solution for such things? I was of the assumption that after the operation urine passing will all be OK. But still need to undergo this dilation process every month once or every two weeks once. Can you help here and guide? Regards, Ambrish

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