Picture source: urethrotomy-source urology-texbook.com
Advantages (+):
- simple procedure
- intervention indicated with the first occurrence of the disease
Disadvantages (-):
- recurrence probability 70% -100%
- each section in the scarred urethra leads to a new scar with a renewed narrowing by what the scarring gets larger and longer
- creating a opening for the urine flow becomes increasingly difficult in scarred tissue
- the disease worsens with every additional procedure
- repeated slots can cause irreparable damage of the urethra
The urethrotomy in detail
Internal urethrotomy
Urethrotomy as a form of therapy can only be considered if the narrowing of the urethra occurred for the first time. The narrowing also has to be less than two centimeters long. If so, the restriciton can be splitted. For the urethrotomy the patient receives either a general anesthetic or a local anesthetic in the medulla. While the patient is sedated the endoscope is guided into the urethra to split the constriction with a knife. The urethra must be splinted with a catheter for a few days after the surgery.
The cut in the scarred urethra leads to a new wound which also cicatrize. This scar is normally larger as the split scar. Because of that the situation usually worsens. With the first adaption the urethrotomy is successful in less than 30% of treated patients. After the second slitting the recurrence probability is 100%. When this form of therapy is used regularly it leads to a further scarring of the urethra. Thereby the healing of the disease is more difficult. As a consequence a huge number of patients must bear an indwelling catheter.