Name of the Procedure

Dilation of Urethral Stricture or Vesical Neck by Passage of Sound or Urethral Dilator in Males (General or Conduction (Spinal) Anesthesia)

Summary

This procedure involves widening a narrowed section of the urethra or the neck of the bladder using a sound or dilator. General or spinal anesthesia is used to ensure the patient is comfortable and pain-free during the procedure.

Purpose

The procedure is performed to address a urethral stricture or narrowing of the bladder neck, which can cause difficulties with urination. The goal is to improve urine flow and reduce symptoms such as frequent urination, incomplete bladder emptying, and urinary retention.

Indications

• Difficulty urinating or weak urine stream
• Frequent urination
• Painful urination
• Urinary retention or incomplete bladder emptying
• Recurrent urinary tract infections

Preparation

• Patients may be instructed to fast for a specific period prior to the procedure.
• Medications, especially blood thinners, may need to be adjusted under medical guidance.
• Pre-procedure tests such as urine analysis, blood tests, and imaging studies might be required to assess the condition.

Procedure Description

1. The patient is administered either general or spinal anesthesia.
2. The urethral opening is cleansed and sterilized.
3. A lubricated sound or dilator is gently inserted into the urethra up to the point of the stricture.
4. The dilator is carefully and gradually advanced to widen the narrowed area.
5. The process may be repeated with progressively larger dilators until achieving the desired dilation.
6. Once dilation is complete, the instruments are removed, and the area is cleaned.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the complexity of the stricture.

Setting

• Hospital operating room
• Outpatient surgical center

Personnel

• Urologist or surgeon
• Anesthesiologist
• Surgical nurses

Risks and Complications

• Infection
• Bleeding
• Urethral injury
• Pain during and after the procedure
• Recurrence of the stricture

Benefits

• Improved urine flow
• Relief from symptoms of pain and discomfort
• Reduced risk of urinary tract infections
• Enhanced quality of life

Recovery

• Patients may need to stay in a recovery area for a few hours post-procedure.
• Instructions will be provided for managing discomfort and preventing infection.
• Temporary catheterization might be required.
• Most patients can resume normal activities within a few days, although straining and heavy lifting should be avoided.
• Follow-up appointments are essential to monitor healing and ensure the stricture does not recur.

Alternatives

• Urethral stent placement
• Surgical urethroplasty
• Internal urethrotomy
• Each alternative has its own risks and benefits, which should be discussed with the healthcare provider.

Patient Experience

• During the procedure, patients will be under anesthesia and should not feel pain.
• Post-procedure, there may be mild discomfort or a burning sensation during urination, which can be managed with pain relief medications.
• Adherence to post-procedure care instructions is crucial for a smooth recovery and the prevention of complications.