Name of the Procedure:

Cystourethroscopy, with steroid injection into stricture

Summary

Cystourethroscopy with steroid injection into a stricture is a medical procedure where doctors use a thin tube with a camera to look inside the bladder and urethra. During the procedure, they inject steroids into narrowed areas (strictures) to reduce inflammation and improve urine flow.

Purpose

This procedure is designed to treat urethral strictures, which are narrowings of the urethra that can cause difficulty urinating. The goal is to alleviate symptoms, improve urine flow, and prevent further complications like infections or bladder damage.

Indications

• Recurrent urinary tract infections (UTIs)
• Difficulty or painful urination
• Reduced urine stream
• Frequent need to urinate
• Incomplete bladder emptying

Preparation

• Fasting: Typically, no eating or drinking for 6-8 hours before the procedure.
• Medication adjustments: Patients may need to adjust blood thinners or other medications.
• Pre-procedure tests: Urine tests and possibly an ultrasound or imaging studies to assess the stricture.

Procedure Description

1. Anesthesia: Local or general anesthesia may be used to minimize discomfort.
2. Insertion: A cystoscope (a tube with a camera) is inserted through the urethra into the bladder.
3. Visualization: The doctor examines the urethra and bladder to locate the stricture.
4. Steroid Injection: Using the cystoscope, steroids are injected directly into the stricture to reduce inflammation.
5. Completion: The cystoscope is removed, and the patient is moved to recovery.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Urologist or surgeon
• Nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Pain or discomfort
• Temporary difficulty urinating
• Rarely, urethral injury or perforation

Benefits

• Improved urine flow
• Reduced symptoms
• Lower risk of recurrent infections
• Potentially long-term relief from stricture

Recovery

• Short-term: Expect some burning or discomfort during urination for a few days.
• Follow-up: Typically a follow-up visit within 1-2 weeks to assess healing.
• Restrictions: Avoid heavy lifting and strenuous activities for a short period.
• Hydration: Drink plenty of fluids to flush the urinary system.

Alternatives

• Dilation: Stretching the stricture using special instruments.
• Urethroplasty: Surgical reconstruction of the urethra.
• Observation: Monitoring the condition without immediate treatment.
• Pros and Cons: Dilation is less invasive but may need repeating; urethroplasty is more invasive but can provide longer-lasting results.

Patient Experience

• During the procedure: If under local anesthesia, you might feel pressure or mild discomfort. General anesthesia means you'll be asleep.
• After the procedure: Some burning or mild pain during urination, managed with pain relievers.
• Comfort: Follow post-procedure care instructions to minimize discomfort and support healing.