Urethral dilation is a medical procedure in which the urethra is gently stretched with a rubber or metal tube. An abnormal narrowing of the urethra, called a stricture, may inhibit the flow of urine and cause serious health problems, making this procedure necessary. Though urethral dilation is normally performed by a urologist, with proper training and precautions, it can also be performed by a patient.
Conditions Requiring Treatment
This procedure is used to treat urethral strictures. These can be caused by scarring from an injury, repeated bacterial infections like urethritis, a history of Sexually Transmitted Diseases (STDs), or trauma from the insertion of an instrument such as a cystoscope or catheter. Rarely, strictures are also caused by birth defects or tumors. Symptoms of this condition include difficult or painful urination, pelvic pain, and blood in semen or urine. Patients who cannot urinate due to an extremely severe stricture must seek medical attention immediately, since they could be at risk for a bladder or kidney infection or injury, as the pool or urine may become infected, or abscesses may develop.
Those with frequent urinary tract infections may also require occasional treatments. Having repeated infections may be a sign of an unusually narrow urethra. Dilation often helps lower the frequency of these ailments because the bacteria causing them cannot build up as easily in a widened urinary passage.
Procedure
Medical professionals usually perform urethral dilation in stages. After the patient is prepped with anesthesia, a smooth metal tube is lubricated and carefully slipped into the urethra. The urologist then repeats the process with incrementally larger sizes of tubes until he or she determines that the urethra is wide enough to easily urinate. This procedure has about a 50% success rate for first-time performances. Some people need annual or semi-annual treatments to ensure even and painless urination.
Since urinary dilation is not guaranteed to succeed, can lead to discomfort and painful urination afterwards, and can lead to scarring if done incorrectly, some people seek alternative treatments. One of the most common ones is muscle relaxants to release the muscles controlling urination. If urethral dilation is ineffective due to severe pre-existing scarring, surgery may be needed.
At Home Treatment
With proper training, a patient can perform urethral dilation at home with different sized catheters. The benefits of doing this include immediate attention to the problem and increased comfort and privacy. The procedure typically involves gently cleaning the genitals with a soapy washcloth or disinfectant wipe and then slipping a lubricated catheter into the urethra. Patients should move very slowly and never shove or force the catheter. Self-dilation may drain the bladder; many patients prefer to do this in the bathroom for this reason.
Precautions
People who self-dilate should be trained by a medical professional to avoid accidentally tearing the urethra or causing an infection. Doctors may also prescribe a course of antibiotics to reduce risk of infection. All adverse symptoms that occur during self-treatment should be reported to a health care provider immediately. This includes pain during dilation, painful urination afterwards, or blood in the urine.