Urethral bougienage

Bougienage is a minimally invasive urological procedure during which a doctor gradually dilates a narrowed section of the urethra using special instruments — bougies. It is used mainly for urethral stricture — narrowing of the urethra due to the formation of scar tissue. The procedure makes it possible to increase the lumen of the urethra, restore its patency, and facilitate urination.

If you have noticed that your urine stream has become weaker, urination is difficult, or a sensation of incomplete emptying of the bladder has appeared, do not postpone visiting a doctor. You can book a consultation with a urologist at Oxford Medical through the online booking form on the website or by calling the contact center.

Prolonged narrowing of the urethra can lead to incomplete emptying of the bladder, urinary retention, and recurrent urinary tract infections, in particular, cystitis may occur. In severe cases, impaired urine outflow can negatively affect kidney function. Therefore, it is important to restore the patency of the urethra in a timely manner to prevent the development of complications.

The procedure has a number of contraindications. In the presence of acute inflammation or injury, the procedure is postponed, and if it is impossible to safely dilate the urethra, another method of restoring its patency is chosen.

Contraindications include:

• Acute urinary tract infections. Bougienage is postponed until the infection has been treated and the inflammation has decreased.

• Recent urethral injury. First, the doctor determines the nature of the damage and chooses further management tactics. The possibility of bougienage is considered after healing.

• Bleeding from the urethra of unknown origin. Before the procedure, it is necessary to establish its cause.

• Complete obstruction of the urethral lumen. If it is impossible to pass an instrument through the narrowed section, bougienage is not performed.

• Damage to the urethral wall with the formation of a false passage. In such a case, insertion of a bougie may aggravate the injury, so the doctor considers other methods of restoring urethral patency.

Acute infections, injuries, and bleeding may be temporary contraindications. After these conditions have been resolved, the doctor reassesses the possibility of performing the procedure. If bougienage is impossible or is associated with a high risk of urethral damage, the patient is offered another treatment method.

Bougienage of the urethra is usually performed under local anesthesia using a gel with lidocaine. More complex interventions may require general anesthesia. During the procedure, the urologist sequentially inserts bougies into the urethra, gradually increasing their diameter to dilate the narrowed section and restore urine outflow.

The main stages of the procedure:

• Preparation and anesthesia. The external opening of the urethra is treated with an antiseptic, after which an anesthetic gel with lidocaine is introduced into the urethra. If general anesthesia is planned, it is administered by an anesthesiologist before the intervention begins.

• Insertion of the instrument. The urologist carefully passes a bougie through the urethra. For more complex strictures, a guidewire may be used to safely pass through the narrowed section.

• Gradual dilation. The doctor sequentially uses instruments of a larger diameter to stretch the urethra and increase its lumen.

• Completion of the procedure. After the required diameter is achieved, the instruments are removed. If indicated, a urinary catheter is inserted for a certain period of time.

Doctors at Oxford Medical explain that patients often ask whether urethral bougienage is painful. Thanks to anesthesia, the procedure is usually tolerated without significant pain, but sensations of pressure and discomfort are possible. If sharp pain occurs during the insertion of the instrument, the doctor should be informed immediately.

According to Alberta Health Services, stretching of the urethra may be accompanied by temporary irritation of its mucous membrane. After the procedure, mild burning during urination, discomfort in the urethra, and hematuria (small amounts of blood in the urine) are possible. Usually, unpleasant symptoms decrease within 1–2 days.

After the procedure, it is recommended to:

• drink enough water if there are no restrictions on fluid intake;

• avoid intense training, lifting heavy objects, and other significant physical exertion during the first few days;

• temporarily abstain from sexual intercourse for the period recommended by the urologist;

• if a urinary catheter has been inserted, follow the care instructions and come for its removal at the specified time.

You can usually return to normal daily activities after 1–2 days. The exact period depends on the extent of the procedure, the type of anesthesia, and how you feel.

Doctors at Oxford Medical recommend monitoring urination during the first few days after the intervention. If urine stops flowing, blood clots appear, severe pain occurs, the temperature rises, or chills develop, it is necessary to seek medical assistance urgently.

The cost of urethral bougienage differs for men and women due to the anatomical features of the urethra and the technique used to perform the procedure. You can find the current prices for medical services here.

To book an appointment with a urologist at Oxford Medical, use the online booking form on the website or contact the contact center.

The information is for informational purposes only and does not replace a doctor's consultation.

Sources:

• European Association of Urology

• NCBI Bookshelf

• U.S. National Library of Medicine