Name of the Procedure:

Excision or Fulguration of Urethral Prolapse

Summary

Excision or fulguration of urethral prolapse is a surgical procedure to remove or destroy prolapsed tissue in the urethra (the tube that carries urine from the bladder to the outside of the body).

Purpose

The procedure addresses the medical condition of urethral prolapse, where the mucosal layer of the urethra protrudes outside the urethral opening. The goal is to alleviate symptoms such as discomfort, urinary issues, and bleeding, and to restore normal function and appearance.

Indications

• Visible protrusion of urethral tissue
• Discomfort or pain in the genital area
• Urinary issues such as difficulty urinating or incontinence
• Bleeding or spotting from the urethra
• Recurrence of urethral prolapse after non-surgical treatments

Preparation

• Fasting for a certain period before the procedure, as instructed by the healthcare provider
• Adjustment or temporary discontinuation of certain medications, especially blood thinners
• Pre-procedure diagnostic tests such as a urinalysis or physical examination

Procedure Description

1. The patient is administered local or general anesthesia to ensure comfort.
2. The surgeon isolates and visualizes the prolapsed tissue.
3. Excision involves carefully cutting away the prolapsed tissue. Fulguration uses electrical current to destroy the prolapsed tissue.
4. Sutures may be placed to repair and secure the remaining urethral tissue.
5. The area is cleaned and dressed.

Duration

The procedure typically lasts about 30 minutes to 1 hour.

Setting

The procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Urologist or gynecologist (surgeon)
• Anesthesiologist
• Surgical nurses
• Surgical technician

Risks and Complications

• Infection at the surgical site
• Bleeding
• Injury to surrounding tissues, including the bladder or vagina
• Scarring or narrowing of the urethra
• Recurrence of urethral prolapse

Benefits

• Relief from discomfort and pain
• Improvement in urinary function
• Reduction or elimination of bleeding
• Enhanced quality of life
• Immediate results in most cases

Recovery

• Post-procedure instructions may include resting and avoiding vigorous activities.
• Pain management with prescribed medications.
• Keeping the surgical area clean and dry.
• Follow-up appointments to monitor healing.
• Full recovery typically occurs within a few weeks.

Alternatives

• Conservative management such as topical estrogen cream
• Pessary placement
• Observation without immediate intervention
• Pros of conservative methods include non-invasiveness; cons may include recurrence or persistence of symptoms.

Patient Experience

The patient may experience some discomfort or mild pain post-procedure, which can be managed with medications. Temporary swelling or bruising might not be unusual. Following post-operative care instructions will help ensure a smooth recovery.