These are both endoscopic and minimally-invasive techniques that can be used to open up the urethra when there is a stricture or scar tissue.
A urethrotomy (sometimes called a optical or internal urethrotomy) is performed by passing a camera (cystoscope) down the urethra and cutting into the scar tissue with a small knife. There may be some bleeding afterwards, and very often you may be left with a catheter for a few days in order for things to settle.
A urethral dilatation is an older technique where successive dilators of increasing size, (starting with very fine dilators and working upwards) are passed down the urethra to stretch the scarred urethral tissue and open up the blockage.
The results of these techniques are often temporary, with success rates varying between 0 and 50% in the medium term. They can be combined with a programme of ‘self-dilatation’ afterwards to try and extend the effects of the urethrotomy or dilatation.
You may have been offered or received one of these to treat your stricture, or had repeated endoscopic treatments in the past. If so it is important to at least have had a discussion regarding the possibility of a urethroplasty (see urethroplasty section) as a more long-term and effective treatment for your stricture.
Although it is not possible to treat every stricture with a urethroplasty, a discussion about your individual stricture and situation, along the pros and cons of a more permanent solution versus the less durable endoscopic treatments is certainly going to be worthwhile.
Here at LMC we can offer and discuss all options of urethral stricture management with you, and offer a bespoke and individualised management plan according to your specific needs.