Urethral stricture is a narrowing of the urethra that can obstruct the flow of urine from the bladder.
During urethroplasty, the narrowed or scarred portion of the urethra is repaired or reconstructed to create a wider passage for urine.
Why might I need Urethroplasty?
- Difficulty or straining while passing urine
- Weak or spraying urinary stream
- Prolonged time to empty the bladder
- Recurrent urinary tract infections
- Incomplete bladder emptying
- Recurrent urethral stricture after dilatation or internal urethrotomy
- Significant narrowing demonstrated on urethrogram or urethroscopy
How is Urethroplasty performed?
The technique depends on the location, length, and severity of the stricture.
Common approaches include:
1. Excision and Primary Anastomosis (EPA)
The scarred segment is removed and the two healthy ends of the urethra are joined together. This is commonly used for selected short bulbar urethral strictures.
2. Buccal Mucosal Graft Urethroplasty
A small piece of tissue is taken from the inside of the cheek (buccal mucosa) and used to widen or reconstruct the narrowed urethra. This is commonly used for longer strictures where simply joining the two ends is not appropriate.
3. Other Reconstruction Techniques
Long or complex strictures may require staged reconstruction or other graft/flap techniques. Your urologist will select the technique according to your individual anatomy.
Urethral catheter may remain for few weeks, depending on the type and complexity of urethroplasty.
Care at Home
- Keep the catheter and surgical area clean.
- Drink fluids according to your doctor's advice.
- Take prescribed medicines regularly.
- Walk gently and regularly.
- Avoid strenuous exercise until your surgeon permits it.
- Avoid heavy lifting for the recommended period.
- Avoid activities that put pressure on the perineum, such as cycling, until cleared by your surgeon.
- Attend all scheduled follow-up appointments.
- Avoid constipation and excessive straining.
If a Buccal Mucosal Graft Was Used The inside of the cheek usually heals naturally and may take 2-3 months.
Frequently Asked Questions (FAQs)
Is urethroplasty a major operation?
Urethroplasty is a reconstructive urological operation performed under anesthesia. The complexity varies according to the location and length of the stricture and the technique required.
Will urethroplasty cure my urethral stricture?
Urethroplasty provides a durable repair for many patients and generally has a higher long-term success rate than repeated dilatation or internal urethrotomy. However, stricture recurrence is possible.
Can the stricture come back?
Yes. Although urethroplasty is highly effective, recurrence can occur. Regular follow-up helps detect recurrence early.
Will my urinary stream become normal?
Many patients experience a significant improvement in urinary flow after successful urethroplasty. The degree of improvement depends on the condition of the bladder, the severity and duration of obstruction, and other urinary problems.
Will I need another operation?
Most patients do not need another operation after a successful repair. However, recurrent or complex strictures may occasionally require additional treatment.
If tissue was taken from my cheek, will it affect eating?
There may be temporary discomfort when chewing or eating. Most patients gradually return to normal eating as the cheek heals.
Will taking a graft from my cheek leave a scar?
Buccal mucosa is taken from inside the mouth, so there is generally no visible external facial scar.
When can I return to work?
This depends on your occupation and the type of urethroplasty. Desk-based work may be resumed earlier than physically demanding work.
When can I have sexual intercourse?
You can have regular sexual intercourse following catheter removal
Can urethroplasty affect erections?
Temporary changes in sexual function can occur after some urethroplasty procedures, particularly when the surgery involves the perineum. Most patients do not experience permanent erectile dysfunction, but individual risk depends on the location and complexity of the surgery.
Contact:
Dr Arun Shah
MCh Urology
National Urology Center, Janakpur
9744427743