Name of the Procedure:

Excision or Fulguration of Urethral Polyp(s), Distal Urethra

Summary

This procedure involves the removal or destruction of polyps located in the distal (end) portion of the urethra. Polyps are small, benign growths that can cause various urinary symptoms.

Purpose

To treat symptomatic urethral polyps that may cause discomfort, urinary difficulties, or obstruction. The goal is to alleviate symptoms, improve urinary flow, and prevent potential complications.

Indications

• Recurrent urinary tract infections (UTIs)
• Hematuria (blood in the urine)
• Difficulty urinating or urinary obstruction
• Pain during urination
• Visible polyps at the urethral opening

Preparation

• Fasting may be required a few hours prior, especially if general anesthesia is planned.
• Adjustments to medications (e.g., blood thinners) as directed by the healthcare provider.
• Diagnostic evaluations such as cystoscopy, urine tests, and imaging studies to assess the urethral polyps.

Procedure Description

1. Anesthesia: Local anesthesia or sedation may be administered to keep the patient comfortable.
2. Excision or Fulguration:
   • Excision: The surgeon uses specialized instruments to cut and remove the polyp(s).
   • Fulguration: Uses electric current (electrocautery) to destroy the polyp tissue.
3. Inspection: The urethra is inspected to ensure all polyp tissue is removed or destroyed.
4. Closure: If necessary, small sutures may be used.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

Performed in an outpatient surgical center or hospital operating room.

Personnel

• Urologist or surgeon
• Nursing staff
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Bleeding
• Infection
• Urethral stricture (narrowing)
• Pain or discomfort during urination
• Recurrence of polyps

Benefits

• Relief from urinary symptoms
• Improved urinary flow
• Reduced risk of urinary tract infections
• Generally quick recovery time

Recovery

• Patients are usually able to go home the same day.
• Mild discomfort or burning sensation during urination is common for a few days.
• Instructions may include pain management, drinking plenty of fluids, and avoiding heavy lifting or strenuous activities.
• Follow-up appointments to monitor healing and ensure no recurrence.

Alternatives

• Watchful waiting if the polyps are asymptomatic and small.
• Medications to manage symptoms if excision or fulguration is not immediately necessary.
• Non-invasive procedures such as laser treatment or cryotherapy.

Patient Experience

• Minimal to moderate discomfort during the procedure.
• Post-procedure burning sensation during urination, managed with analgesics.
• Quick return to normal activities, with specific aftercare instructions to ensure proper healing.