What is Urethrotomy?
Urethrotomy in children is a surgical procedure aimed at addressing urethral strictures or blockages to restore normal urine flow. This procedure is crucial for alleviating symptoms and preventing potential kidney damage. Here’s what you need to know about this specialized intervention.
Types of Urethrotomy
Different approaches are used depending on the stricture’s length, location, and severity:
- Optical Internal Urethrotomy (OIU): The most common technique, where a thin endoscope with a blade or laser is used to cut through the stricture under direct vision.
- Cold Knife Urethrotomy: Uses a small surgical blade to precisely cut the scar tissue causing the blockage.
- Laser Urethrotomy: A laser beam is used instead of a blade to vaporize the scar tissue, ensuring minimal bleeding and faster healing.
30-60 Minutes
Surgery Duration
General or Spinal Anesthesia
Anesthesia Used
2-3 Weeks
Full Recovery Timeline
Indications for Urethrotomy
Congenital and Acquired Conditions
Urethrotomy is indicated for various conditions that cause urethral narrowing:
- Congenital Strictures: Narrow urethra present from birth.
- Trauma-Induced Strictures: Resulting from accidents or medical procedures.
- Infection-Related Strictures: Chronic infections leading to urethral scarring.
- Urethral Valves: Abnormal tissue obstructing urine flow.
- Symptomatic Relief: Addresses pain, recurrent infections, or difficulty urinating.
- Preventing Kidney Damage: Ensures normal urine flow to prevent kidney complications.
- Failure of Other Treatments: When non-surgical methods are ineffective.
Who Needs Urethrotomy?
Urethrotomy is recommended when symptoms suggest a narrowing of the urethra or urinary obstruction.
Common symptoms that may indicate the need for urethrotomy include:
- Weak or slow urine stream
- Straining or difficulty while urinating
- Incomplete bladder emptying
- Frequent urination or urgency
- Pain or burning sensation during urination
- Blood in urine (hematuria)
- Recurrent urinary tract infections (UTIs)
- Dribbling of urine or urinary retention
How to Prepare for Urethrotomy
- Preoperative Evaluation: Urine flow tests, cystoscopy, and imaging (retrograde urethrogram) to identify stricture site.
- Fasting: Usually 6-8 hours before surgery.
- Medication Review: Certain medications, such as blood thinners, may need adjustment.
- Hydration and Hygiene: Adequate hydration and genital hygiene before surgery.
- Hospital Admission: Usually on the same day or a day before the procedure.
Steps Involved in Urethrotomy?
Steps Before Urethrotomy
Preparation is essential for a successful surgery and includes:
- Preoperative Assessment: Comprehensive evaluation of health and medical history.
- Consultation with Surgeons: Discussion of risks, benefits, and expectations.
- Fasting and Medication Management: Necessary preparations for anesthesia.
- Emotional and Physical Readiness: Explanation of the procedure and comfort measures.
During the Surgery
The surgical process involves:
- Anesthesia and Incision: Administering general anesthesia and making a precise incision in the narrowed urethra.
- Instrumentation: Using a cystoscope with a camera and surgical tools.
- Post-Incision Management: Possibly placing a temporary stent or catheter for healing support.
Recovery Post Urethrotomy
Managing recovery includes:
- Immediate Recovery: Monitoring vital signs and initial healing.
- Pain Management and Catheter Care: Providing comfort and ensuring proper urinary function.
- Antibiotics and Follow-Up: Preventing infections and scheduling necessary check-ups.
Monitoring and Long-Term Follow-Up
Ongoing care involves:
- Scheduled Appointments: Monitoring healing progress and overall recovery.
- Addressing Concerns: Open communication for adjusting care as needed.
- Preventing Complications: Educating parents on signs of potential issues.
Benefits of Urethrotomy
- Restores normal urine flow
- Relieves urinary pain and discomfort
- Minimally invasive with small or no external incision
- Quick procedure and short recovery period
- Can be repeated if necessary for recurrent strictures
- Improves bladder emptying and quality of life
Risks of Urethrotomy
Though generally safe, potential risks include:
- Bleeding or infection after the procedure
- Recurrence of urethral stricture
- Temporary urinary discomfort or burning
- Scar tissue formation
- Rarely, urinary retention or injury to nearby tissues
How Much Does Urethrotomy Cost in India?
- Standard Procedure: Rs. 45,000 - Rs. 1,00,000
- Laser Urethrotomy: Rs. 70,000 - Rs. 1,50,000+
Costs depend on hospital type, anesthesia, surgical method, and post-operative care.