It is most often performed in the outpatient setting, with the patient (usually) being discharged from the hospital or surgery center within six hours from the procedure's inception.

[1] Beginning in 2003, several urology residency programs in the northeastern section of the United States began advocating the use of urethrotomy as initial treatment in the young stricture patient, versus urethral dilatation.

An IV antibiotic or other anti-infective medication is administered in conjunction with intravenous normal saline, and allowed to run until administration of the prescribed dose is completed.

The cystoscope (and injection system) will be withdrawn, and sufficient time will be allowed for the local anesthetic to take effect (usually five-to-ten minutes).

The Foley catheter serves two purposes, first, it provides drainage of the urine produced in the kidneys, and secondly, it secures the incised areas, holding them open for three to seven days to permit thorough healing of the urethra.

After voiding, and using sterile technique, a lubricated Foley catheter is passed into the urethra, through the surgically modified area, into the bladder and allowed to remain in place for up to ten minutes.

[5] Many leading urologists in the United States consider urethrotomy to be (almost) totally ineffective at providing long-term resolution of urethral stricture disease, and advocate excision of the damaged area followed by either a surgical anastomosis of the (now) patent urethral ends, or a grafting of similar tissue harvested from elsewhere on the patients body.

In the May, 2006 issue of "Urology", a study undertaken by the Urology Department of the University of Washington essentially concluded that there is a statistical correlation between the length of the stricture and the cost versus benefit ratio of subsequent urethrotomies performed prior to the performance of urethroplasty in males suffering from bulbar strictures.

[citation needed] Comparing the two surgical procedures, a UK trial found that both urethrotomy and urethroplasty are effective in treating urethral stricture in the bulbar region.

[8][9] The results were integrated into the new UK guidelines on the treatment urethral narrowing by British Association of Urological Surgeons.