Why do I need a Urethral dilation?
Urethral dilation (also known as Meatal dilation) is a procedure that may be recommended if you have as narrowed segment in your urethra or urethral opening due to scar tissue, which is causing an obstruction to the urinary stream.
What does the procedure involve?
Stretching of a narrowed urethra or urethral opening (meatus) to improve the flow of urine.
What are the alternatives to this procedure?
Alternatives to this procedure include:
- Meatoplasty - surgical enlargement of the urethral opening.
- Optical urethrotomy.
- Urethroplasty - open (non-telescopic) surgical repair of the narrowed segment of urethra.
- No treatment / observation of symptoms.
What should I expect before the procedure?
You will usually be admitted to hospital on the same day as your surgery. You may receive an appointment for a “pre-assessment” clinic to assess your general fitness for anaesthesia.
You will be asked not to eat and drink for six hours before surgery.
Immediately before the operation, the anaesthetist may give you a pre-medication, which will make you dry-mouthed and pleasantly sleepy.
Please tell your surgeon (before your surgery) if you have any of the following:
- An artificial heart valve.
- A coronary artery stent.
- A heart pacemaker or defibrillator.
- An artificial joint.
- An artificial blood-vessel graft.
- A neurosurgical shunt.
- Any other implanted foreign body.
- A regular prescription for a blood thinner e.g. Warfarin, Coumadin Xarelto®, Pradaxa®, Clopidogrel (Plavix®), Brilinta®, or Aspirin.
- Previous or current infection with an antibiotic resistant organism such as MRSA, VRE, etc.
What happens during the procedure?
A full general anaesthetic or sedation is normally used and you will be asleep throughout the procedure. You will usually be given an injection of antibiotics before the procedure, after you have been checked for any allergies. The anaesthetist may also use an epidural or spinal anaesthetic to reduce the level of pain afterwards.
The urethra or urethral opening is stretched using metal (pictured) or plastic dilators, after inserting local anaesthetic jelly to numb and lubricate their passage.
What happens immediately after the procedure?
Once you are urinating normally after the procedure you will be allowed to go home. Occasionally it may be necessary to place a catheter in the urethra (water pipe) after the procedure, which will be removed after a day or two.
Are there any side-effects?
Most procedures are straightforward; however as with any surgical procedure there is a chance of side effects or complications.
Common (greater than 1 in 10)
- Mild burning or bleeding on passing urine for a short period after the operation.
- Temporary insertion of a catheter.
- Recurrent stricture formation requiring repeated dilatation.
Occasional (between 1 in 10 and 1 in 50)
- Urinary tract infection (UTI).
- Damage to the urethra resulting in a “false passage” and the need for further surgery.
Rare (less than 1 in 50)
- Infection around the urethra resulting in abscess formation.
- Delayed bleeding requiring removal of clots or further surgery.
What should I expect when I get home?
You will not be able to drive for at least 24 hours after a general anaesthetic. You should be able to return to most normal activities after 24 hours.
When you get home, you should drink twice as much fluid as you would normally for the first 24 to 48 hours to flush your system through. When you first pass urine, you may find that it stings or burns slightly and it may be lightly bloodstained. If you continue to drink plenty of fluid, this discomfort and bleeding will resolve rapidly.
What else should I look out for?
If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact your Surgeon immediately. If out of hours, please go to your nearest emergency department.
Are there any other important points?
You may need to learn to pass a catheter or dilator into the penis to help the widened urethra stay open. If so, you will be instructed in this technique by a urology nurse.
This information is intended as a general educational guide and may not apply to your situation. You must not rely on this information as an alternative to consultation with your urologist or other health professional.
Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.