The procedure
A fine endoscope is passed into the urethra and the scar is incised under direct vision with a cold knife or laser. Dilatation instead stretches the narrowing with graded dilators. Both take fifteen to twenty minutes, usually as day-care, with a catheter for one to three days.
Who it suits
Short strictures under about 1.5 cm, in the bulbar urethra, that have never been treated before. For these, a single urethrotomy has a reasonable chance of a durable result.
- A first-time short stricture
- Patients unfit for longer reconstructive surgery
- Urgent relief of retention before planned definitive repair
- A holding measure while a urethroplasty is scheduled
The honest limitation
Recurrence after a second urethrotomy is very high, and every repeat adds scar. If you have already had one procedure and the flow has fallen again, a urethroplasty usually offers a better long-term answer than a third attempt. Uroflowmetry every few months after the procedure catches a recurrence early, while options are still wide.
Urethral Dilatation / Optical Urethrotomy — common questions
How long does relief last after urethrotomy?
Anywhere from months to years. A short first-time stricture does best; recurrent strictures often narrow again within a year.
Is the procedure painful?
It is done under spinal or general anaesthesia. Burning for a few days afterwards is common.
How many times can urethrotomy be repeated?
Repeating beyond twice is rarely worthwhile. At that point reconstruction should be discussed properly.
Will I need a catheter afterwards?
Usually for one to three days, sometimes slightly longer depending on the stricture.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains urethral dilatation / optical urethrotomy in general terms; your own treatment plan depends on your reports and examination.