Urethrotomy

Urethrotomy
ICD-10-PCS	58.0
OPS-301 code	5-580

A urethrotomy is an operation which involves incision of the urethra, especially for relief of a stricture.

Direct visual internal urethrotomy (optical urethrotomy) uses an endoscopic device known as a urethrotome. This is inserted up the urethra to the stricture and an extendible knife (or laser) is used to make the incisions.

Despite the popularity of urethrotomy for treating urethral strictures in men, the success rate is less than 10% initially and may drop to zero over time.

Urethrotomy is a popular treatment for male urethral strictures. However, the performance characteristics are poor. Success is less than 9% for first or subsequent urethrotomy. Most patients will be expected to experience failure with longer followup and the expected long-term success rate from any urethrotomy approach is 0%. Beginning in 2003, several urology residency programs in the northeastern section of the United States began advocating the use of urethrotomy as initial treatment in the young stricture patient, versus urethral dilitation. It is theorized that the one-to-two years of relief from stricture disease will allow the practitioner and the patient to plan the most effective treatment regimen without having the concern that undergoing multiple dilitations cloud the judgment of the patient. Furthermore, should urethroplasty be selected by the patient, minimal scar tissue will have developed at the site of the stricture in the urethrotomy patient, as opposed to the patient who had undergone the more conventional (dilitation) route.