Special Surgical Procedures II
LESSON 3: Procedures in Genitourinary Surgery
Section v: operations on the scrotum, penis, and urethra
3-42
3-42. URETHRAL DILATATION AND INTERNAL URETHROTOMY
a. General. This procedure involves the gradual dilatation and removal of a urethral stricture to provide for adequate urinary drainage of the kidney.
b. Operative Procedure for Gradual Dilatation. The urethra is lubricated and anesthetized. In the male patient, the penis is clamped and the urethra anesthetized. A filiform bougie is passed through the urethral stricture into the bladder. Sounds or followers of desired type attached to filiform bougies are then passed into the bladder.
c. Operative Procedure for Internal Urethrotomy. The filiform bougie is passed into the bladder; the urethrotome is connected and inserted. The Otis urethrotome consists of a curved sound with a groove on its upper side, along which is a triangular knife. Its sides are sharp and its apex blunt. The urethrotome is inserted, and then the blade is released to cut the stricture. Electrosurgical cutting and coagulating electrodes may be used.
