Urethrectomy (removal of the male urethra or water pipe)

What is this?

Removal of the male urethra (water pipe) because of cancer or the risk of cancer development, usually performed through an incision in the perineum (behind the scrotum).

What alternatives are there?

Radiotherapy to try to kill or prevent cancer in the urethra, conservative treatment

What to expect before procedure

If you are taking Aspirin or Clopidogrel on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits. You will usually be admitted on the day before surgery. Your general fitness, to screen for the carriage of MRSA will be assessed and sometimes some baseline investigations performed prior to your admission. This can, on occasions, be done by telephone or you may be asked to attend a pre-admission clinic approximately 14 days before your admission, depending on your medical history. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Normally a full general anaesthetic will be used and you will be asleep throughout the procedure. In some patients, the anaesthetist may also use an epidural anaesthetic which improves or minimises pain after the operation. You will usually be given injectable antibiotics before the procedure to prevent infection, after checking for any allergies. In the operation, through a small incision, the urethra will be identified and removed from the level of the prostate just below the arch of the pubic bone to the tip of the penis.

After the procedure

A drainage tube will be placed in the wound to drain fluid away from the internal area where the operation has been done. After your operation, you may return to the Intensive Care Unit or the Special Recovery area of the operating theatre before returning to the ward. You will normally have a drip in your arm. You will be encouraged to mobilise as soon as possible after the operation because this encourages the bowel to begin working. We will start you on fluids and food as soon as possible. We normally use elastic stockings to minimise the risk of a blood clot (deep vein thrombosis) in your legs. A physiotherapist will show you some deep breathing and leg exercises and you will sit out in a chair for a short time after your operation. The average stay in hospital will last approximately 5-7 days.

Potential side effects