Dr Jo Schoeman
Urological Surgeon

        

Optic Urethrotomy

Product Summary: AMA rates

Endoscopic cutting open of urethral stricture with cold knife.

Item Number: 37327, 105

Why is it done?

  • To treat a narrowing in the urethra which has formed due to previous damage/injury to the urethra.
  • Causes: after bypass surgery where a drop in blood pressure has caused an area of low blood supply to the urethra; trauma to the urethra (pelvic fractures/ urethral instrumentation); and sexually transmitted diseases.
  • The procedure entails cutting the stricture with a cold knife.
  • It also prevents eventual kidney damage/failure.

Pre-requirements

  • An informed consent is required from the patient and a pre-admission clinic appointment will be arranged.
  • Patients may not eat or drink from midnight the previous evening.
  • Patients are to refrain from smoking before the procedure.
  • Patients allergic to IODINE/CHLORHEXIDINE should clearly state this at pre-admission clinic as well as to theatre staff and Dr Schoeman.
  • • Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery, this may be replaced by once daily Clexane injections.
  • • Patients with cardiac illnesses require a cardiologist/physician’s report.
  • • A chest X-ray is required for patients with lung disease.
  • • Pre-Op blood tests are required 4 days prior to surgery.
  • • Be prepared for an overnight stay.

How is it done?

  • Patients will receive a general anaesthetic.
  • A urethroscopy is performed by placing a camera in the urethra, with the help of a lubricant jelly and an irrigant (fluid), to identify the stricture.
  • A cold knife is then used to cut the stricture open.
  • The inside of the bladder is viewed for pathology.
  • If any suspicious lesions are seen, a biopsy will be taken.
  • Prophylactic antibiotics may be given to prevent infection.

What to expect after the procedure?

  • Any anaesthetic has its risks and the anaesthetist will explain such risks.
  • A catheter will be inserted in the urethra and bladder. This will remain in the bladder for 3 days.
  • Catheters can be very irritating and cause some discomfort.
  • Blood stained urine will be present.
  • Lower abdominal discomfort will persist for a few days.
  • NB! Each person is unique and for this reason symptoms may vary!

What next?

  • Patients will spend the night in hospital.
  • Patients will be sent home with a catheter for 3 days after receiving thorough catheter care instructions.
  • Arrangements will be made to remove the catheter on day 3.
  • There may be some blood in the urine. This can be remedied by drinking plenty of fluids until it clears.
  • On discharge a prescription may be issued for patients to collect.
  • Patients should schedule a follow-up appointment with Dr Schoeman within 4 weeks.
  • Should patients have any problems with urination, please contact the rooms for an earlier appointment.
  • Please don’t hesitate to direct any further queries to Dr Schoeman’s rooms.
  • PLEASE CONTACT THE HOSPITAL WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

Optic Urethrotomy Optic Urethrotomy (643 KB)