Therapy for urethral narrowing

A narrowing of the urethra is treated surgically. This will come in generally two sets of procedures, the Harnröhrenschlitzung or open surgery.


Urethral slotting
The Urethral slotting is also called urethrotomy. The procedure is performed in partial or general anesthesia. Here then is an optical instrument (urethrotome) inserted into the urethra up to the point where the narrowing occurs. Then the restriction is extended with a small knife or a laser probe. Then for 24 hours, a permanent catheter is placed.


Chances of success very differently
The prognosis for the Urethral slotting are between 20 and 70 percent. These differences arise from the fact that more scar tissue develops in some patients that contract it. This creates a re-narrowing. A repeated occurrence of narrowing can occur up to 3 years after slitting. The risk of such recurrence can be reduced by bougienage. At a dilatation of the urethra is widened by a catheter or a metal pin (Bougie). Still in the experimental stage is the insertion of a tube (stent), which holds open the narrowed point.


Open surgery with different methods
The open surgery is performed primarily in a long segment of narrowing or constriction of the urethra with recurrence after slitting. With open surgery, the urethra is opened from the outside. There are different methods:

    For a shorter contraction (up to 2 cm) is the restriction point and cut out the two ends of the urethra are reconnected. The prognosis for this procedure are 80 to 95 percent.
    If it is a longer stricture, the urethra at the stricture is cut lengthwise and sewn to a piece of tissue expansion. This piece of tissue may consist of oral mucosa, penile skin or foreskin. It is taken before the surgery. The procedure is known as onlay plasty. For better healing with this method, a catheter is placed abdominal wall through which the urine can flow. The urethra is using a bladder catheter is left in place for about 8 days, kept open.