Urethrotomy

Abstract

In a book primarily concerned with the management of urinary incontinence it may seem out of place to have a chapter describing procedures specifically designed to reduce urethral resistance. These may be necessary in two situations: (a) when urinary infection is a recurring problem and (b) when incomplete bladder emptying occurs, which may also be associated with incontinence. Recurring infections may result from either inefficient but compete emptying, or incomplete emptying resulting from a decompensated detrusor—that is, one which produces a good contraction to initiate voiding but is unable to maintain its contraction. In these cases urethral resistance may be normal or raised. Neurological disease may affect both the detrusor and sphincter function, causing detrusor-sphincter dyssynergia which may result in incontinence although the urethral resistance may be higher than normal.