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.
- 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!
- 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 (643 KB)