Name of the Procedure:

Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent

• Common name(s): Urethral Dilation, Urethral Sounding
• Medical terms: Urethral Dilation

Summary

Urethral dilation is a medical procedure used to treat a narrowing of the urethra (urethral stricture) in men. During the procedure, specialized instruments called sounds or dilators are gently passed through the urethra to widen the narrowed area and improve urinary flow.

Purpose

• Medical condition: Urethral stricture, a condition where the urethra becomes narrowed due to scar tissue.
• Goals: To alleviate symptoms such as difficulty urinating, painful urination, frequent urinary tract infections, and complete urinary retention.

Indications

• Symptoms like weak urine stream, straining to urinate, and incomplete bladder emptying.
• Recurrent urinary tract infections.
• Previous history of urethral stricture requiring intervention.
• Diagnostic confirmation of urethral narrowing through imaging or endoscopy.

Preparation

• Patients may be instructed to fast for a few hours before the procedure.
• Adjustments to medications, particularly blood thinners, might be necessary.
• Pre-procedure assessments may include urine tests, imaging studies, or urethroscopy.

Procedure Description

1. The patient is positioned comfortably, usually lying on their back.
2. Local anesthesia or a mild sedative may be administered to minimize discomfort.
3. The healthcare provider inserts a lubricated sound or dilator into the tip of the penis and gradually advances it through the urethra.
4. Larger sizes of dilators are progressively used to stretch the stricture area.
5. The process is repeated until the urethra reaches the desired diameter.

Tools and Equipment

• Urethral sounds or dilators of various sizes.

Anesthesia

• Local anesthesia or mild sedation as needed.

Duration

The procedure typically takes approximately 15 to 30 minutes.

Setting

• Generally performed in an outpatient clinic or a urology office.

Personnel

• Urologist or trained healthcare provider.
• Assisted by a nurse or medical assistant.

Risks and Complications

• Common risks: Discomfort, minor bleeding, urinary tract infection.
• Rare risks: Urethral trauma, creation of false passages, severe bleeding, fever.

Benefits

• Improvement in urinary flow and relief from obstructive urinary symptoms.
• Reduced risk of urinary tract infections and prevention of complete urinary retention.
• Benefits may be realized immediately or shortly after the procedure.

Recovery

• Patients are advised to drink plenty of water and may be prescribed antibiotics to prevent infection.
• Mild discomfort or a small amount of blood in the urine may occur for a day or two.
• Follow-up appointments with the urologist are often necessary to monitor progress and determine if repeat dilation is required.

Alternatives

• Periodic self-catheterization.
• Internal urethrotomy.
• Surgical repair (urethroplasty).
• Each alternative has its own pros and cons related to the severity of the stricture, recurrence rates, and overall patient health.

Patient Experience

• During the procedure: Pressure or stretching sensation is common; discomfort varies with the severity of the stricture and patient's tolerance.
• After the procedure: Mild discomfort, increased frequency of urination, or slight burning during urination may be experienced.
• Pain management: Over-the-counter pain relievers can be used to manage any discomfort.