A urethroplasty, also known as a urethral reconstruction, is an open surgery to repair a urethral stricture. The types of surgeries we offer are varied and also depend upon the location, cause, and length of the stricture. Most surgeries take between three to six hours to complete.
Usually, an incision is made over the area of the stricture in the penis, scrotum, or perineum (the area between the scrotum and the anus). After surgery, a urethral catheter is left in for two to four weeks depending upon the type of surgery that was performed.
Recovery times for a urethroplasty depends on the type of surgery that was performed on the patient. Most patients will be in the hospital overnight after surgery. As soon as they can eat, walk, and care for their catheter they are able to leave the hospital. It is important to limit activities after this procedure until adequate healing has taken place. This means no heavy lifting, strenuous exercise or work for at least two weeks.
It is best if patients do not work while the catheter is in place, however, patients can start doing work that is not physical after 10–14 days. The catheter can be worn draining to a smaller bag that straps to the lower leg under a pair of pants. Wearing a catheter like this is very manageable and unobtrusive.
The follow-up appointment after a urethroplasty is extremely important. This is because most urethral strictures can recur within the first year or two after surgery. Patients are required to have follow up appointments every three to six months in their first year after surgery.
If and when strictures come back after surgery they often are thin and web-like. These strictures can cause obstructions but often can be treated internally by cutting the stricture with a scope procedure. This is not similar to the initial stricture that often has too much scarring to respond long-term to an internal cutting procedure. Some strictures are too dense and do not respond to internal cutting and the patient may need further surgery.
As for most surgical procedures, different surgeries have different success rates. Generally, strictures can be resolved in 75–85 percent of cases. Should your strictures come back, only about one half cause symptoms. For example, if a stricture comes back, it has to be very tight to cause blockage of urinary flow, just like the original stricture.
If patients have symptoms, then an internal cutting surgery with a scope is usually tried (direct vision internal urethrotomy). If this doesn’t work, then patients may need additional surgery, which is rare.
To book a consultation with our team about urethroplasty please contact the clinic.