Internal urethrotomy (urethral stricture)

A urethral stricture is a narrowing of the channel that carries urine from the bladder to the outside. It is caused by scar tissue after an infection, an injury, a urinary catheter or an endoscopic procedure, and sometimes no cause is found. It mainly affects men. Internal urethrotomy opens the narrowing from the inside. The urologist passes an endoscope fitted with a small blade (or a laser) through the urethra and cuts the narrowed area under direct vision. A urinary catheter is left in place for a few days so that the channel heals in an open position. The procedure is best suited to short, single strictures, particularly as a first treatment. For long, multiple or recurrent strictures, reconstructive surgery of the urethra (urethroplasty) may be more appropriate; the urologist discusses this with the patient. At Clinique Pasteur Tunis, the work-up includes uroflowmetry, urethrography or cystoscopy to measure the stricture. The procedure is performed in the operating theatre with a short hospital stay and regular follow-up.