What is Urethral Dilation?
Urethral dilation is a procedure used for the treatment of a medical condition called urethral strictures. The procedure is also known as meatal dilation.
The urethra is a tube through which urine, stored in the bladder, is passed outside the body. A urethral stricture is an abnormal area of constriction along the length of the urethra that reduces or obstructs the flow of urine. It is more common in males as the urethra is longer, passing through the penis and prostate gland. Urethral strictures usually occur due to inflammation and scar tissue formation in the urethra.
A Urethral dilation procedure involves stretching the narrowed urethral opening (meatus) or sides of the urethra using various techniques such as metal or plastic dilators or inflating a balloon to clear the obstruction and improve urine flow.
Indications and Contraindications for Urethral Dilation
Urethral dilation is commonly indicated for the treatment of urethral strictures (scarring from infection, injury, or swelling) and meatal stenosis (narrowing of the urethral opening at the end of the penis). The main goal of the urethral dilation procedure is to stretch the scar tissue without harming the lining of the urethra.
Contraindications for a urethral dilation procedure include bleeding and untreated infection.
Preparation for Urethral Dilation
Pre-procedure preparation for urethral dilation may involve the following steps:
- A thorough examination is performed by your doctor to check for any medical issues that need to be addressed prior to the procedure.
- Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure.
- You will be asked if you have allergies to medications, anaesthesia, or latex.
- You should inform your doctor of any medications or supplements that you are taking or any medical conditions you have such as lung or heart disease.
- You may need to refrain from certain medications such as blood thinners or anti-inflammatories for a week or two prior to the procedure.
- You should not consume any solids or liquids at least 6 hours prior to the procedure.
- Arrange for someone to drive you home after the procedure, as you may feel groggy due to the effects of anesthesia/sedation medicines.
- A written consent will be obtained from you after the procedure has been explained in detail.
Procedure for Urethral Dilation
In general, the urethral dilation procedure involves the following steps:
- You will be asked to lie down on the procedure table in a supine position on your back.
- General anesthesia or sedation medicines are administered to keep you asleep or calm and relaxed throughout the procedure.
- You will also be given an antibiotic injection prior to the procedure to prevent any risk of infection.
- Your anesthetist may also utilize spinal or epidural anesthetic to decrease the level of pain after the procedure.
- A local anesthetic jelly is inserted into the urethra to lubricate and numb the urethral passage.
- Your surgeon will then carefully insert instruments such as metal or plastic dilators into the urethra from the tip of the penis (meatus) to stretch the urethra or urethral opening. Your physician may also use other techniques such as passing a catheter tube with a balloon into the urethra and slowly inflating the balloon to stretch the narrowed area.
- Once satisfactory treatment is confirmed, the tools will be withdrawn, and a tube called a urinary drainage catheter may be placed to help pass urine while you heal.
- The procedure usually takes about 30 minutes to complete.
- Urethral dilation may need to be repeated from time to time as strictures may recur.
Post-Procedure Care and Recovery
Post-procedure care and instructions may involve the following:
- You will be transferred to the recovery area where you will be asleep until the sedation or anesthesia wears off. Your nurse will monitor your vital signs as you recover.
- It is normal for you to feel soreness or pain in the urethra due to the instruments used for dilation. You will be given pain and anti-inflammatory medicines to address this.
- Medications may also be prescribed as needed for symptoms associated with anesthesia, such as vomiting and nausea.
- You should be able to resume your normal activity and diet by the next day, unless your physician instructs otherwise.
- You will mostly be discharged home the same day of the procedure or the next day once you are able to pass urine normally.
- A follow-up appointment will be scheduled to monitor your progress.
Risks and Complications
Urethral dilation is a relatively safe procedure; however, as with any surgical procedure, some risks and complications may occur, such as:
- Burning or pain on urination
- Adverse reactions to anesthesia
- Need to repeat dilation due to recurrent stricture formation