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Urethroplasty

Overview

Urethroplasty is a surgical procedure to repair or reconstruct the urethra, the tube that carries urine from the bladder to the outside of the body. It is primarily used to treat urethral strictures, a narrowing or blockage in the urethra that can cause difficulty in urination, urinary infections, or complete urinary retention. Urethroplasty restores the normal flow of urine and improves the patient's quality of life.
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Kumar Saurav
Dr. Kumar Saurav
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Raj Kumar Choudhuri
Dr. Raj Kumar Choudhuri
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How is Urethroplasty done?

Medical Evaluation:

A thorough assessment is conducted, including medical history, physical examination, imaging (urethrogram), and possibly cystoscopy.

Preoperative Testing:

Blood tests, urinalysis, and any necessary imaging tests.

Medication Review:

Certain medications (e.g., blood thinners) might need to be paused before surgery.

Anesthesia Consultation:

Since urethroplasty requires general or spinal anesthesia, a consultation is needed to ensure there are no complications related to the patient's overall health.

Pre-Surgery Instructions:
  • Fasting Avoid food and drink at least 6-8 hours before surgery.
  • Smoking and Alcohol Avoid prior to surgery to minimize complications.

Anesthesia:

The patient is placed under general or spinal anesthesia.

Incision and Exposure:

A small incision is made in the perineum (area between the scrotum and anus) to access the urethra.

Urethral Stricture Excision or Repair:
  • Excision and Primary Anastomosis: The scarred part of the urethra is removed, and the healthy ends are reconnected.
  • Substitution Urethroplasty: If the stricture is too long, a graft (from buccal mucosa or other tissues) may be used to reconstruct the urethra.
Catheter Placement:

A catheter is typically placed to allow urine to flow while the urethra heals.

Closure:

The incisions are closed, and the patient is moved to recovery.

The procedure can take between 2 to 5 hours depending on the complexity of the repair.

While urethroplasty is generally considered safe, there can be complications, including:
  • Infection: Post-operative infections may occur at the surgical site or within the urinary tract.
  • Bleeding: Mild to moderate bleeding may occur during or after surgery.
  • Urethral Fistula: An abnormal connection between the urethra and surrounding tissues, which might need further surgery.
  • Recurrence of Stricture: In some cases, the stricture may return, necessitating further treatment.
  • Urinary Incontinence: Difficulty in controlling urine flow postoperatively.
  • Erectile Dysfunction: Rare but possible after certain urethral repairs.

Special caution is advised for people with recent heart surgery, pneumothorax, or certain respiratory infections.

What are the benefits Urethroplasty?
  • Restores Normal Urinary Flow: Relieves symptoms of urinary obstruction and discomfort.
  • Reduces Infections: Decreases the risk of recurrent urinary tract infections associated with urethral strictures.
  • Improves Quality of Life: Allows patients to resume normal activities without the burden of stricture symptoms.
  • Durable Results: The success rates for urethroplasty are high, and it often provides a permanent solution compared to other treatments like dilation or urethrotomy.

Infrastructure & Facilities

  • Operating Room: Equipped with surgical instruments for urology procedures.
  • Anesthesia Equipment: To provide general or regional anesthesia.
  • Imaging Facilities: Pre-operative diagnostics (ultrasound, urethrogram) are essential.
  • Post-Surgery Recovery Area: For monitoring the patient immediately after surgery.
  • Urology Ward: For hospitalization, especially for complex procedures requiring prolonged recovery.
  • Catheterization Supplies: Essential for postoperative care.

FAQs

Most patients can resume normal activities within 2 to 4 weeks, but full recovery may take 3 months or more. Strenuous activities and heavy lifting should be avoided until cleared by a doctor.

Pain is typically well managed with medications. Patients may experience some discomfort in the early post-operative period but should gradually improve.

A catheter is usually left in place for 2 to 3 weeks after surgery to allow the urethra to heal properly.

Recurrence rates vary, but urethroplasty is highly effective with success rates between 85-90%. Long-term follow-up is essential.

For sedentary jobs, most patients return within 2 to 4 weeks. Physically demanding jobs may require 6 weeks or more.

While rare, erectile dysfunction can occur, particularly if the stricture is located near the base of the penis. Most patients, however, experience no long-term issues.

Alternatives include dilation or endoscopic urethrotomy, but these often provide only temporary relief, especially for long or complex strictures. Urethroplasty offers a more permanent solution.

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Copyright 2025 TRSCH - All Rights Reserve

Website Design and Development by Sterco Digitex

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