Fraud Blocker

Same Day Appointments Available

Call Us At +65‎ 6334‎ 1486
[email protected]
Search
Asian Healthcare Specialist
Asian Healthcare Specialist

Call Us

+65‎ 6334‎ 1486
Make an Enquiry

Call Us

+65‎ 6334‎ 1486
Make an Enquiry

Urethrotomy in Singapore

Living with a urethral stricture can impact daily life, potentially causing difficulty urinating, frequent urinary tract infections, and discomfort that may affect overall well-being. If you’re experiencing these symptoms, this is a condition that affects many men and can be addressed through appropriate medical intervention.

Urethrotomy, also known as direct vision internal urethrotomy (DVIU), is an established endoscopic procedure designed to treat urethral strictures by widening the narrowed areas of the urethra. This minimally invasive approach may relieve urinary symptoms and help restore standard urination patterns. In Singapore, urologists perform this procedure using contemporary endoscopic equipment to help patients improve their quality of life.

doctor img
Dr. Nor Azhari Bin Mohd Zam

MBBS (NUS)|MRCS (Edin.)|MMed Surgery (NUS)|FAMS (Urology)

Make an Enquiry
Photo 2 Urethrotomy in Singapore
Suitability Techniques Process Recovery Benefits Risks Cost FAQ Conclusion
Jump to section…
Suitability
Techniques
Process
Recovery
Benefits
Risks
Cost
FAQ
Conclusion

What is Urethrotomy?

Urethrotomy is a surgical procedure that makes precise incisions in scar tissue within the urethra to widen narrowed areas called strictures. The urethra is the tube that carries urine from the bladder out of the body. When it becomes narrowed due to scarring, it can cause urinary problems.

This procedure uses a specialised instrument called a urethrotome, which combines a telescope for visualisation with a cutting mechanism. The urologist identifies the strictured segment and makes controlled incisions to open the narrowed area, which may help urine to flow more freely. The procedure is performed under direct visualisation, hence the term “direct vision internal urethrotomy.”

Urethrotomy addresses various causes of urethral strictures, including trauma from previous catheterisation, infections, pelvic fractures, or previous urological procedures. The treatment has been used for many years and is considered an option for managing short strictures. The procedure doesn’t remove the scar tissue entirely, but it aims to open the channel to help restore urine flow.

Who is a Suitable Candidate?

Ideal Candidates

Ideal Candidates

  • Men experiencing difficulty starting urination or a weak urine stream (symptoms that are also common in patients requiring benign prostatic hyperplasia treatment)
  • Patients with confirmed urethral stricture on diagnostic testing
  • Individuals with strictures of limited length
  • First-time stricture patients or those with limited previous interventions
  • Patients experiencing recurrent urinary tract infections due to stricture
  • Those with incomplete bladder emptying, causing retention
  • Men considering minimally invasive treatment options
  • Patients who can tolerate cystoscopy procedures
Contraindications

Contraindications

  • Extensive or multiple strictures
  • Complete urethral obliteration with no visible lumen
  • Active urinary tract infection requiring treatment first
  • Severe bleeding disorders or anticoagulation that cannot be stopped
  • Previous multiple failed urethrotomy attempts
  • Strictures involving the posterior urethra extensively
  • Patients unable to maintain follow-up care requirements

Determining candidacy requires thorough evaluation by a urologist, including urethrography or cystoscopy to assess stricture characteristics. Your urologist may consider factors such as the stricture’s location, length, and prior treatments to recommend the most appropriate approach for your specific situation.

Treatment Techniques & Approaches

  • Cold Knife Urethrotomy

    Cold-knife urethrotomy is a recognised technique for treating urethral strictures. This approach uses a sharp blade attached to the urethrotome to make incisions in the scar tissue. The urologist typically makes the incision at the 12 o’clock position, though additional cuts at 3 and 9 o’clock positions may be considered for denser strictures. This technique allows for controlled cutting depth and aims to minimise thermal damage to surrounding tissues.

  • Laser Urethrotomy

    Laser urethrotomy uses focused laser energy to vaporise or incise the stricture tissue. Common laser types include holmium and potassium titanyl phosphate (KTP) lasers. This technique offers tissue ablation with simultaneous coagulation, which may help reduce bleeding. The laser approach may be considered for recurrent strictures or for dense fibrotic tissue.

  • Technology & Equipment Used

    Modern urethrotomy employs endoscopic equipment, including high-definition cameras for enhanced visualisation, specialised urethrotomes with various blade configurations, and irrigation systems to maintain clear vision during the procedure. Some centres use flexible cystoscopes for navigation through complex anatomy. The choice of equipment depends on structural characteristics and clinical considerations.

Considering treatment options?

Dr Azhari can evaluate your specific condition and discuss suitable approaches.

Schedule Consultation

The Treatment Process

Pre-Treatment Preparation

Before your urethrotomy, you’ll undergo urine testing to rule out active infection, which must be treated before the procedure. Blood tests may be required to assess clotting function and overall health. You’ll need to stop blood-thinning medications as advised by your urologist.

On the day of surgery, you’ll fast if general anaesthesia is planned. Arrange for someone to drive you home after the procedure, as you shouldn’t drive immediately following anaesthesia. Your surgical team can confirm consent and mark the operative site as part of standard safety protocols.

During the Procedure

The procedure begins with anaesthesia – either spinal or general, depending on your preference and medical suitability. Once comfortable, you’ll be positioned appropriately, and the genital area may be cleaned with an antiseptic solution.

Your urologist can carefully insert the urethrotome through the urethral opening and advance it to visualise the stricture. Using the camera system, they’ll identify the location and extent of narrowing. The cutting mechanism is then deployed to make incisions through the scar tissue.

The procedure duration varies depending on the structural complexity. Throughout, saline irrigation maintains clear visualisation and removes any debris. Once the stricture is incised, the urologist confirms urethral patency before completing the procedure.

Immediate Post-Treatment

Following the procedure, you’ll recover in the post-anaesthesia care unit where nursing staff monitor your vital signs and comfort level. A urethral catheter is inserted to keep the urethra open during initial healing and allow bladder drainage. Patients may experience mild discomfort or a burning sensation, which is managed with appropriate pain medication.

You may be discharged the same day or after an overnight stay, depending on the type of anaesthesia and your recovery progress. Before discharge, you’ll receive detailed catheter care instructions and prescriptions for antibiotics to prevent infection and pain relief medication as needed.

Recovery & Aftercare

First 24-48 Hours

During the initial recovery period, expect some blood in your urine, which is normal and gradually clears. Drink plenty of water to help flush the urinary system. The catheter may remain in place and requires careful management to prevent displacement or infection.

Pain may be mild and can be managed with oral medications. Avoid strenuous activities, heavy lifting, or exercises that could cause the catheter to move. Watch for signs of infection, such as fever, increasing pain, or cloudy, foul-smelling urine, and contact your urologist if these occur.

First Week

The catheter may be removed during a follow-up visit, typically within several days after the procedure. After catheter removal, you may experience temporary burning during urination and urgency, which can gradually improve. Continue drinking plenty of fluids to maintain good urine flow and support healing.

Return to light activities and work may be possible within a few days of catheter removal. Sexual activity may need to be avoided for at least 2 weeks or as advised by your urologist. Continue prescribed antibiotics for the full course to help prevent infection.

Long-term Recovery

Healing can occur over several weeks, during which the urethra re-epithelialises over the incised area. Regular follow-up appointments may include uroflowmetry tests to monitor urine flow and assess treatment outcomes.

Some patients may require intermittent self-catheterisation training to maintain urethral patency and help prevent re-stricturing. Long-term monitoring may be recommended, as strictures can recur and require surveillance with periodic flow studies or cystoscopy. Your urologist may establish an appropriate follow-up schedule based on your specific case.

Our urologist provides post-procedure support to help with recovery.

Schedule your consultation to learn more about what to expect.

Schedule Consultation

Benefits of Urethrotomy

Urethrotomy may help improve urinary function for suitable patients. The procedure aims to address obstructive symptoms and can help restore urine flow, supporting bladder emptying. This may help reduce the risk of urinary tract infections and address discomfort associated with straining to urinate.

The minimally invasive nature of the procedure typically results in shorter recovery times than open surgical options. Patients may be able to return to normal activities within a timeframe that varies by individual circumstances, generally shorter than that for more extensive reconstructive procedures. The procedure preserves urethral length and doesn’t preclude future treatment options if needed.

Quality of life improvements may include better sleep patterns, increased confidence in daily activities, and reduced anxiety related to urinary symptoms. The procedure’s effectiveness in appropriately selected patients can provide long-term symptom management.

Risks & Potential Complications

Common Side Effects

Temporary bleeding or blood in urine may affect patients but typically resolves within a few days. Mild burning or discomfort during urination may be expected after catheter removal and can improve gradually. Some patients may experience temporary urinary frequency or urgency as the bladder adjusts to improved emptying.

Mild urethral discharge or spotting may occur during healing. These effects are generally self-limiting and may be managed with simple measures such as increased fluid intake and pain relief.

Rare Complications

Stricture recurrence is a long-term concern that can occur, though this varies based on stricture characteristics and patient factors. A urinary tract infection can occur and requires prompt treatment.

Patients may experience temporary urinary incontinence, particularly stress incontinence with coughing or straining. Erectile dysfunction is rare but has been reported, particularly with posterior urethral strictures. Urethral perforation during the procedure is a rare but serious complication that would be managed immediately by the surgical team.

Risk minimisation involves careful patient selection, meticulous surgical technique, and adherence to post-operative care instructions. Individual results and timelines may vary. This treatment is administered as part of a comprehensive plan supervised by a urologist.

Cost Considerations

The cost of urethrotomy in Singapore varies based on several factors, including the complexity of your stricture, the type of anaesthesia required, and whether additional procedures are needed. Hospital facility fees, urologist’s fees, anaesthetist charges, and post-operative care are typically included in the overall cost structure.

The procedure may be performed as day surgery or require an overnight stay, affecting total expenses. Pre-operative investigations, such as urethrography or uroflowmetry, add to the initial assessment costs but are essential for proper treatment planning.

The quality of care and the urologist’s experience need to be considered when evaluating treatment options. While cost is essential, your urological team and the facility’s capabilities may impact treatment outcomes. During your consultation, you’ll receive a detailed cost breakdown tailored to your specific treatment requirements.

Frequently Asked Questions

How long does a urethrotomy take to perform?

The procedure may take approximately 15-30 minutes, though this can vary depending on the stricture complexity and location. Total time in theatre may be longer—often 45-60 minutes—accounting for anaesthesia preparation and recovery. Patients may spend 2-4 hours in the hospital for day-surgery cases or stay overnight if required.

Will I need to have a urethrotomy again in the future?

Stricture recurrence is possible. Various factors may influence this, including stricture length, location, and cause. Some patients may maintain good results for extended periods, while others might need repeat procedures or alternative treatments. Regular follow-up helps detect early recurrence, and strategies like intermittent self-catheterisation may help maintain results.

Can I return to work after urethrotomy?

Patients with desk jobs may return to work 3-5 days after the procedure, once the catheter is removed and initial discomfort subsides. Those with physically demanding jobs may need 1-2 weeks before resuming complete duties. Heavy lifting and strenuous activities need to be avoided for at least 2 weeks to allow proper healing.

What’s the difference between urethrotomy and urethroplasty?

Urethrotomy is a minimally invasive endoscopic procedure that cuts through strictures internally without removing tissue. Urethroplasty is an open surgical reconstruction that excises the strictured segment and reconstructs the urethra using grafts or local tissue. While urethroplasty may have different long-term outcomes, it requires a longer recovery. Urethrotomy is often considered first for suitable strictures due to its minimal invasiveness.

How painful is urethrotomy recovery?

Patients may experience mild to moderate discomfort rather than severe pain. The catheter may cause some irritation, and there may be burning during urination for the first week after catheter removal. Discomfort is typically managed with oral medications, and patients often don’t require strong painkillers beyond the first few days. The discomfort is generally less than with open surgical procedures.

Can strictures be prevented from recurring after urethrotomy?

While recurrence cannot be prevented entirely, several strategies may help maintain results. These include intermittent self-catheterisation to keep the urethra open during healing, avoiding urethral trauma, promptly treating urinary infections, and maintaining good hydration. Your urologist can discuss specific prevention strategies based on your individual risk factors.

What happens if urethrotomy doesn’t work?

If urethrotomy is unsuccessful or strictures recur, alternative treatments are available. These include repeat urethrotomy with adjunctive treatments, urethral dilation, or urethroplasty surgery. Some patients may manage with intermittent self-catheterisation. Your urologist can discuss the most appropriate options based on your specific situation and preferences.

Conclusion

Urethrotomy represents a minimally invasive treatment option for appropriately selected patients with urethral strictures. The procedure aims to restore normal urination with a relatively short recovery period.

Understanding the procedure, recovery process, and long-term management helps you make an informed decision about your treatment. With proper patient selection, the experienced surgical techniques characteristic of our circumcision clinic Singapore and comprehensive urology practice, and appropriate follow-up care, urethrotomy may help definitively relieve symptoms and improve quality of life.

Ready to Take the Next Step?

If you’re considering urethrotomy for urethral stricture treatment, Dr Azhari can help you understand if it’s a suitable option for your needs. With experience in endoscopic urological procedures, we provide personalised care throughout your journey.

Book Your Consultation Today
Dr. Nor Azhari Bin Mohd Zam

Dr. Nor Azhari Bin Mohd Zam

MBBS (NUS)|MRCS (Edin.)|MMed Surgery (NUS)|FAMS (Urology)

With more than 15 years experience as a certified Urologist, Dr Nor Azhari specializes in treating a wide range of kidney, bladder and prostate conditions as well as disorders of the male reproductive organs.

He offers minimally invasive treatment options and provides same-day appointments for convenience.

  • Skilled urologist and kidney stone surgeon.
  • Director of Endourology (Urinary stone service) at Singapore General Hospital – 2016 to 2023.
  • Recognized with the College of Surgeons Gold Medal and Singapore Urological Association Book prize.
  • Minimally invasive treatment options available (non-invasive and endoscopic/key-hole techniques).
contact us

Make an Enquiry

For urgent or same day appointment requests, please call our hotline.

    Full Name*

    Email Address*

    Phone Number*

    Your Message*

    For Faster Response, call us!

    +65‎ 6334‎ 1486

    Our Clinic Locations

    Asian Healthcare Specialists (Novena)

    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road
    #08-41 Singapore 329563

    +65‎ 6334‎‎ 1486
    [email protected] [email protected]

    Asian Healthcare Specialists (Alvernia)

    Mount Alvernia Hospital
    820 Thomson Road Medical Centre Block A #05-03 Singapore 574623

    +65 6252 4015
    [email protected]