Special Surgical Procedures II
LESSON 3: Procedures in Genitourinary Surgery
Section v: operations on the scrotum, penis, and urethra
3-40
3-40. URETHRAL MEATOTOMY
a. General. This involves incisional enlargement of the external urethral meatus. The procedure is done to relieve stenosis or stricture.
b. Patient Preparation. For the male, a supine position is generally used, and the penis is elevated on a small folded sheet. For the female, the lithotomy position is used. Either general or topical anesthesia may be used. Cocaine 5 percent is used for the meatus and 2 percent procaine with bulb syringe is used for instillation into the urethra.
c. Operative Procedure. A straight hemostat is applied to the ventral surface of the meatus. An incision is made along the frenulum to enlarge the opening and overcome the stricture. Bleeding vessels are clamped and ligated with fine plain surgical gut sutures. The mucosal layer is sutured up to the skin with fine plain gut sutures. A dressing of petrolatum gauze may be applied.
