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Urination is a normal bodily function that eliminates body waste from the system. We often take it to be a very normal and mundane activity, but it is very important for the well-being of a person. Trouble with urination is a condition most often observed in the elderly. Urethroplasty is a surgery to repair a damaged or narrowed urethra. The urethra is the tube that carries urine from the bladder to the outside of the body.
Synopsis
Why is Urethroplasty Required?
Urethroplasty is most commonly used to treat urethral strictures, which are narrowings in the urethra. Strictures can be caused by several things, including:
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Trauma - Injury to the pelvis or urethra can cause scarring and narrowing.
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Infection - Infections of the urethra, such as urethritis, can also cause scarring.
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Inflammation - Conditions such as Crohn's disease and lichen sclerosus can cause inflammation of the urethra, which can lead to scarring.
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Congenital defects - Some people are born with urethral strictures.
What Happens in a Urethroplasty Before, During and After the Procedure?
Urethroplasty can be performed in several ways, depending on the location and severity of the stricture. The most common type of urethroplasty is called open urethroplasty. In open urethroplasty, the surgeon makes an incision in the perineum (the area between the scrotum and the anus) to access the urethra.
Before Urethroplasty
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Preoperative Assessment: Undergo imaging studies like urethrography to determine the location and length of the stricture.
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Fasting: Refrain from eating or drinking for 6–8 hours prior to surgery.
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Medication Management: Receive prophylactic antibiotics and possibly anticoagulant therapy to prevent infections and blood clots.
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Anesthesia Consultation: Discuss anesthesia options, typically general anesthesia, with your anesthesiologist.
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Transportation Arrangements: Ensure a family member or friend is available to drive you home post-surgery.
During Urethroplasty
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Anesthesia Administration: You'll be placed under general anesthesia to ensure comfort during the procedure.
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Surgical Approach: The surgeon makes an incision in the perineum (area between the scrotum and anus) to access the urethra.
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Stricture Repair: Depending on the stricture's characteristics, the surgeon may remove the narrowed segment and reconnect the urethra (anastomotic urethroplasty) or use tissue grafts, such as buccal mucosa from the inner cheek, to reconstruct the urethra.
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Catheter Placement: A Foley catheter is inserted to maintain urinary drainage during healing, typically remaining in place for 2–3 weeks.
After Urethroplasty
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Hospital Stay: Expect to stay in the hospital for 1–3 days post-surgery for monitoring and initial recovery.
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Pain Management: Manage postoperative discomfort with prescribed pain medications; swelling and bruising are common and should gradually subside.
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Catheter Care: Maintain catheter hygiene as instructed, ensuring it remains securely taped to prevent movement and reduce infection risk.
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Activity Restrictions: Limit physical activity, avoiding heavy lifting and strenuous exercises for at least 4–6 weeks.
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Follow-Up Appointments: Attend scheduled follow-ups to monitor healing progress and remove the catheter once appropriate.
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Return to Work: Plan to take 1–2 weeks off work, or longer if your job involves physical labor.
Visit us as we are known as one of the top urology hospitals in Gurgaon if you want to learn more about urethroplasty surgery steps.
Benefits of Urethroplasty
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Urethroplasty is a very effective surgery for treating urethral strictures. Most people who have urethroplasty can urinate normally after surgery.
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However, there is a small risk that the stricture will recur. In most cases, a second urethroplasty can be performed successfully.
Complications of Urethroplasty
Urethroplasty is a surgical procedure to repair urethral strictures, but like all surgeries, it carries potential complications. Here are some possible complications:
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Stricture recurrence: The urethral narrowing may return, necessitating further treatment.
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Urinary incontinence: Some patients may experience involuntary urine leakage post-surgery.
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Erectile dysfunction: There is a risk of temporary or permanent erectile issues due to nerve damage.
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Urinary tract infections (UTIs): Infections can occur at the surgical site or in the urinary tract.
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Urinary retention: Difficulty in emptying the bladder may occur, sometimes requiring catheterisation.
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Pain or discomfort: Persistent pain in the surgical area can affect quality of life.
Recovery from Urethroplasty
Urethroplasty recovery typically takes 4-6 weeks. During this time, you will need to avoid strenuous activities and sexual intercourse. You may also need to wear a catheter or be prescribed an Ostomy bag for a few days or weeks to allow the urethra to heal properly. For best post-operative care, Manipal Hospitals Gurugram follows strict infection control protocols and patient care routines.
Your doctor will give you specific instructions on how to care for yourself after urethroplasty surgery.
When to See a Doctor?
If you have any of the following symptoms after urethroplasty, you should see a doctor immediately:
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Fever
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Chills
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Severe pain
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Redness, swelling, or drainage from the incision.
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Difficulty urinating
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Blood in the urine
Conclusion
Urethroplasty is a safe and effective surgery for treating urethral strictures. If you are facing issues or difficulties with urination on a frequent basis, consult with a urologist and get a timely diagnosis for precision care. It is always advisable to consult and understand the risks and benefits of a procedure concerning your body and health condition, and our expert doctors are the best doctors in Gurugram for your healthcare needs. Book an appointment or visit your nearest Manipal Hospitals to experience world-class care.
FAQ's
Urethrotomy is a minimally invasive procedure where a surgeon uses a scope to cut through the scar tissue causing the urethral stricture. It's typically performed as an outpatient procedure, but it has a higher recurrence rate over time.
Urethroplasty, on the other hand, is an open surgical procedure that involves removing or reconstructing the narrowed section of the urethra. It has a higher success rate and provides a more permanent solution, especially for longer or recurrent strictures.
Urethroplasty can be performed in one or two stages, depending on the complexity of the stricture.
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Stage 1: An incision is made on the underside of the penis to access the stricture. Scar tissue is removed, and a graft (often from the inside of the cheek) is placed to reconstruct the urethra.
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Stage 2: Several months later, once the graft has healed, the urethra is reconstructed over a catheter to restore normal urine flow.
Urethroplasty is considered the most effective long-term treatment for urethral strictures. It addresses the root cause by reconstructing the urethra, leading to a high success rate and low recurrence.
Postoperative pain is common but usually manageable with prescribed medications. Some patients may experience discomfort or mild pain around the surgical site, which typically subsides within a week.
To schedule a consultation for urethroplasty, you can contact us or visit our website to book a consultation.
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