Urethroplasty is a surgical procedure that treats urethral stricture, a condition that can lead to painful symptoms and urinary complications. Learn more about this treatment.
The purpose of urethroplasty surgery is to treat conditions affecting the urethra, particularly cases of urethral stricture, a condition that causes the narrowing of the channel.
Thanks to advances in surgical techniques, the surgery is effective for different points of narrowing and can significantly improve patients’ quality of life.
Check details about the procedure, from diagnosis to post-surgical care for effective recovery.
What is urethroplasty?
Urethroplasty is the name of the surgical intervention to treat deformities or obstructions in the urethra, the tube that transports urine from the bladder out of the body.
This procedure is especially indicated to treat urethral stricture, a condition that causes narrowing of the urethra, hindering the normal flow of urine.
To perform it, the affected segment of the urethra must be removed, and then reconstruction is done using a tissue graft. Another option is urethral dilation using an instrument, which does not require a graft.
The choice of technique will depend on the severity of the case and the location of the obstruction or deformity.
Read also: Pain in the urinary canal: 05 possible causes and how to treat it
In which cases is urethroplasty indicated?
Urethroplasty is mainly indicated in more severe cases of urethral stricture, i.e., those that do not respond to less invasive treatments, such as urethral dilation or ureterolysis.
However, urethroplasty may also be recommended in cases of:
- Recurrent urethral stricture after previous treatments
- Persistent symptoms affecting quality of life, such as pain when urinating, difficulty starting urination, or weak urine flow
- Frequent urinary infections
- Urinary retention
Signs and symptoms of urethral stricture
The signs and symptoms of urethral stricture can vary depending on the severity of the narrowing. The most common symptoms include:
- Reduced or intermittent urine flow
- Difficulty urinating
- Feeling of incomplete bladder emptying
- Pain or discomfort when urinating
- Frequent urinary infections
- Urinary retention, with bladder distension and pain
These symptoms can significantly impact the quality of life, and in severe cases, they can lead to serious complications, such as kidney damage or systemic infections.
How is urethroplasty surgery performed?
This surgery can be performed in various ways, depending on the type and location of the urethral stricture.
Graft urethroplasty
When the affected segment of the urethra is removed, the defect is repaired with a graft, which can be taken from another part of the body. When the graft is still connected to its original site, the surgery is done with a flap.
Internal incision urethroplasty
For shorter or localized strictures, the technique may involve a small incision in the affected area. For dilation, a stent is inserted.
Diagnosis
The diagnosis of conditions requiring urethroplasty needs a doctor, who will usually request tests such as:
- Urethrography: X-ray of the urethra with contrast to visualize the narrowing;
- Cystoscopy: endoscopic procedure to directly examine the urethra and bladder;
- Urodynamics: test to evaluate bladder function and urinary flow dynamics.
Preparation and surgery
Before urethral stricture surgery, the patient will undergo a series of pre-operative tests to assess their overall health. In addition, they will need to follow some instructions regarding diet, medication use, and other pre-surgery care.
During urethroplasty, the patient will be under general anesthesia.
How long does urethroplasty take?
The duration usually takes between 2 to 4 hours, depending on the complexity of the case.
Procedure risks
Like any surgery, urethroplasty carries risks and potential complications. These include:
- Infections;
- Bleeding;
- Return of the stricture;
- Fistula formation between the urethra and other structures.
In most cases, the surgery provides a long-lasting and effective correction, definitively resolving the condition.
However, it may be necessary to redo the treatment if urethral stricture returns. This tends to happen in patients with predisposition or those who did not correctly follow post-operative instructions.
Post-surgical care
The patient must follow care instructions to ensure proper recovery and minimize the risk of complications.
The main and most complex care is the use of a urinary catheter, which may be necessary in some cases. It will ensure urinary flow and promote healing. Antibiotics and pain medication are also recommended.
The patient should also attend follow-up appointments to monitor recovery and urethral function.
Healing time
Healing time after urethroplasty varies. In general, it takes 6 to 8 weeks, during which activities are more restricted. It may take additional time to fully return to normal routines.
Is it necessary to implant a penile prosthesis after urethroplasty?
The penile prosthesis is not mandatory after urethroplasty, but it may be an option if the patient experiences erectile dysfunction after surgery.
It may be necessary because, in some cases, erectile function may be affected by this surgery or the underlying condition that caused the stricture – often leading to a severe case of erectile dysfunction, which can only be treated with a penile implant.
Take care of your health with Dr. Paulo Egydio
Urethroplasty is an effective intervention to treat urethral stricture, relieving symptoms without causing consequences in most cases, such as erectile dysfunction.
However, this is a condition that can be treated with Dr. Paulo Egydio to keep your sexual health in check. If you need help, don’t hesitate to contact the EMC Clinic.
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