Optical Urethrotomy +- Insertion Allium

Some people experience narrowing of the urethra due to the formation of scar tissue. This can make it very difficult to pass urine. Using a telescope, this scar tissue can be cut/removed with the use of a knife or laser, opening up the channel again to improve urine flow. This small procedure involves an overnight stay in hospital. During the surgery it will be decided if an allium stent is placed immediately or 2 weeks later.

An allium stent is made of an elastic alloy that is flexible and is placed in the urethra to keep the narrowed section open, enabling the passage of urine and preventing tissue regrowth. Insertion of the stent is done as a day procedure only.

An allium stent is made of an elastic alloy that is flexible and is placed in the urethra to keep the narrowed section open, enabling the passage of urine and preventing tissue regrowth. Insertion of the stent is done as a day procedure only.

We will provide you with instructions regarding all aspects of preparing for your operation.

• Pre-operative blood and urine tests.
• Details of admission to hospital.
• Information regarding fasting and medications.

This is generally a very safe procedure with a low risk of complications.

• The chance of infection is <5%.
• Significant bleeding is extremely unlikely as is a blood transfusion.
• The chance of a urethral injury is <1%.

You are usually able to eat and drink what you feel like after the surgery. You will be encouraged to maintain a good fluid intake. It is not usual to have significant pain after this procedure and pain relief is always available. There will most likely be some blood in the urine which should settle within a few days. This operation involves an overnight stay.

You will have a catheter which will be attached to a bag and drains urine from the bladder. A combination of the surgery and the catheter can cause bladder irritation and sometimes bladder spasm. After removal of the catheter there will most likely still be some blood in the urine. Once we can see that you are passing urine satisfactorily, you are then able to go home. You will be given pain relief if required and antibiotics if necessary to take home.

One to two weeks after your optical urethrotomy the allium stent is then placed. This is done as a day procedure. Waiting this time allows for any swelling and/or bleeding to settle. There is a very small possibility that the stent can migrate or fall out all together due to bladder pressure. Please inform us immediately should this occur. Also note that one in five patients will have a secondary bleed at two to three weeks and it is important to be careful around this time.

Please take things quietly for the first 24 hours after surgery. The dressing can be removed the following day. This can be done in the shower. You can wash gently the wound area as soon as the dressing has been removed. Soap and tap water are entirely adequate. Salted water is not necessary. You can shower or take a bath as often as you want. Don’t scrub the wound, pat the wound/s dry with a towel. Wear a pad to keep your underpants clean.

You should drink extra fluid over the first week or two after surgery. Drinking 1500-2000mL per day is usually satisfactory. Do not drink excessively. Aim to keep your urine a pale yellow or straw colour. If you find your urinary symptoms are not improving or become worse, then you could have
an infection. Either contact our office or see your GP to organise a urine test and prescribing of antibiotics.

If you do notice blood in the urine, then drink extra water to dilute the urine. Occasionally there is more excessive bleeding and large clots in the urine that make it difficult to pass. If this occurs, please contact our office, contact your GP, or present to a hospital emergency department for assessment.

You should be able to recommence most of your usual activities shortly after surgery. Please avoid heavy lifting or straining until bleeding settles.

You should not drive for at least 3-4 days after having the operation (or as instructed by your Urologist).

Patients who are travelling outside the metropolitan area are required to check when they are able to travel, and will be required to stay in the metropolitan area for 24 hours (or as instructed by your Urologist).

In the event of an emergency, call our office within business hours and speak to our Practice Nurse. If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.

Ashford Hospital
55 Anzac Highway, Ashford SA 5035
8375 5205
Until 10:00 PM

Flinders Medical Centre (access to Flinders Private Hospital)
Flinders Drive, Bedford Park SA 5042
8204 5511
24 Hours

Calvary Adelaide Hospital
120 Angus Street, Adelaide SA 5000
8227 7027
24 Hours Royal

Darwin Hospital
Rocklands Drive, Tiwi NT 0810
8922 8888
24 Hours

**For patients outside the Metropolitan area, please present to your nearest hospital emergency department.

A post operative appointment will usually be made for you prior to your procedure. Please ask your Urologist, or contact our rooms to ensure arrangements are in place. You are required to do a urine test 3 weeks after the allium stent has been placed as a routine check. You will then have a post operative review a week later (4 weeks post-op) in the consulting rooms with a flow test on the day to ensure your urine flow is satisfactory. A flexible cystoscopy is routinely done at 6 months to monitor correct placement of the allium stent. This is with local anaesthetic as a day procedure only.

If you have any concerns after your procedure, then please contact us at Urological Solutions.

The content provided within this document is intended as a guide only and does not apply to all patients.  Additional information, including patient specific potential risks, must be obtained during consultation with your Urologist.