Optical Internal Urethrotomy: Minimally Invasive Stricture Treatment
A medical procedure used to treat urethral strictures, which are abnormal narrowing of the urethra due to scar tissue or inflammation. Here is an overview of what OIU entails:
Indications
- Treatment of urethral strictures caused by scar tissue or narrowing of the urethra.
- It relieves symptoms such as difficulty urinating, weak urine stream, and frequent urination.
Procedure
- Preparation: Patient may require general or local anaesthesia. The urethra is cleansed, and a cystoscope is inserted through the urethra to visualize the stricture.
- Incision: The surgeon identifies the location of the stricture and makes a precise incision using the optical cutting device (usually a laser or knife).
- Outcome: The incision widens the narrowed urethral segment, improving urine flow.
Advantages
- Minimally invasive: Does not require major surgery or extensive incisions.
- Outpatient procedure: Performed in a clinic or outpatient setting, reducing hospital stay.
- Quick recovery: Patients recover faster compared to open surgical procedures.
- Lower risk of complications like infection and bleeding compared to more invasive surgeries.
Limitations
It relieves symptoms of urethral strictures through precise incisions made with a cystoscope. However, recurrence of strictures is possible, requiring additional treatments. While OIU provides temporary relief from urinary symptoms, it may not offer a permanent cure in all cases. Potential complications include urinary tract infections, bleeding, and rare instances of urethral injury during the procedure.
Post-Procedure Care
- Catheterization: A catheter may be placed temporarily to aid urine drainage and allow the urethra to heal.
- Medications: Antibiotics are prescribed to prevent infection.
- Follow-up: Regular check-ups to monitor healing and address any complications or recurrence.
Alternative Treatments
- Urethral dilation: Mechanical widening of the stricture using progressively larger dilators.
- Open surgical reconstruction: For complex or recurrent strictures not amenable to endoscopic treatment.
Optical Internal Urethrotomy (OIU) is a valuable minimally invasive option for treating urethral strictures, offering effective symptom relief with lower risks compared to more invasive procedures. However, its limitations and potential for recurrence highlight the importance of individualized treatment plans and ongoing patient care.
