Urethral Dilatation
Non-Surgical Widening of the Urethra Using Progressive Dilators
What is Urethral Dilatation?
Urethral Dilatation is the oldest treatment for urethral stricture, involving the progressive introduction of dilators or a Foley catheter to mechanically widen the strictured urethra. While not curative, it provides symptomatic relief and improves urinary flow. Modern dilatation is performed under direct vision or fluoroscopic guidance using balloon or filiform dilators, and is often used in combination with self-dilatation for long-term management. The procedure is performed under general or spinal anaesthesia with a hospital stay of Day Care. Success rates reach 60–70% in appropriately selected patients at experienced centres.
How the Procedure Works
Patient Positioning
The patient is placed in the lithotomy position under local or general anaesthesia.
Filiform Passage
Filiform bougies — very fine flexible probes 3–6 Fr in diameter — are first passed through the stricture under direct vision.
Progressive Dilatation
Serial Hegar metal sounds or van Buren curved sounds of progressively increasing diameter are passed sequentially.
Haemostasis
Resistance during dilation is applied carefully and deliberately — gentle sustained pressure rather than forceful pushing.
Catheter Placement
After dilation to the target calibre, a 14–18 Fr urethral catheter is placed to maintain the lumen.
Outcomes
Who Needs This Treatment?
- →Urethral dilatation is the oldest and most widely practised treatment for urethral stricture.
- →Recurrence rates after urethral dilatation are very high — it is palliative rather than curative for most patients.
- →Clean intermittent self-catheterisation (ISC) by the patient between formal dilatations extends intervals.
- →Fluoroscopic guidance combines contrast cystourethrography with real-time dilation for safer passage.
- →Long-term regular self-dilation (IUSD) is a valid maintenance option for suitable patients.
- →Best suited for elderly patients unfit for surgery or mild strictures after successful urethroplasty.
"While not curative, urethral dilatation has an important role in managing stricture disease. For the right patient, it provides reliable symptomatic relief and can be easily taught as a self-management technique."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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