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Uretheroplasty

Urethroplasty is the surgical repair of the urethra. Urethroplasty may be needed to repair strictures or if there is trauma to the urethra such as a pelvic fracture. Urethral stricture is an abnormal narrowing of the the tube that releases urine from the body. This may be caused by inflammation or scar tissue from surgery, disease, or injury. It may also be caused by external pressure from an enlarging tumor near the urethra, although this is rare. Those with sexually transmitted diseases, repeated episodes of urethritis, or benign prostatic hyperplasia (BPH) are at increased risk. Insertion of any instrument inserted into the urethra (such as a catheter or cystoscope) increases the chance of developing urethral strictures.

The symptoms associated are:

  • Dysuria (painful urination)
  • Difficulty urinating
  • Slow urine stream (may develop suddenly or gradually)
  • Spraying of urine stream
  • Decreased urine output
  • Increased urinary frequency or urgency
  • Incontinence
  • Blood in the semen
  • Pelvic pain
  • Lower abdominal pain
  • Bloody or dark urine
  • Discharge from the urethra
  • Swelling of the penis
  • Urinary retention

A physical examination may reveal the following:

  • Decreased urinary stream
  • Enlarged or tender lymph nodes in the inguinal (groin) areas
  • Redness or swelling of the penis
  • Urethral discharge
  • Enlarged or tender prostate
  • Distended bladder
  • Hardness (induration) on the under surface of the penis

The Tests performed may include the following:

  • Urinary flow rate may be measured
  • Post-void residual (PVR) measurement
  • Urinalysis
  • Urine culture (if evidence of infection)
  • Tests for chlamydia and gonorrhea
  • Cystoscopy to confirm diagnosis
  • A retrograde urethrogram to confirm diagnosis
BRIEF ABOUT THE PROCEDURE

Urethroplasty is an open surgical procedure for urethral reconstruction to treat urethral stricture. There are 2 ways on how a Urethroplasty can be done.

Primary Repair
This involves a complete incision of the narrowed part of the urethra. Next, the proximal and distal patent parts are then joined together.

The second method of Urethroplasty makes use of a tissue transfer or a free graft technique. Here, the surgeon grafts tissue from bladder epithelium, or buccal mucosa and uses it to enlarge the narrowed segment of the urethra./p>

There are no drug treatments currently available for this disease. If all else fails, a urinary diversion -- appendicovesicostomy (Mitrofanoff procedure) -- may be performed to allow the patient to perform self-catheterization of the bladder through the abdominal wall.

After Surgery

  • Swelling, bruising, and spotty bleeding from the penis is normal
  • The stitches will dissolve in about two weeks
  • You may go home with a catheter in your bladder

Recovery

  • Keep your wound clean and dry. You may shower 4 days after surgery. Shower with your back to water as much as possible. Do not soak in a bathtub, hot tub, or swimming pool for the first two weeks
  • Wait for 4 weeks before having sex
  • Avoid all strenuous activity for 2 weeks

Congenital pediatric strictures are rare, as are true strictures in women.

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HOSPITALS FOR URETHEROPLASTY
DESTINATIONS FOR URETHEROPLASTY

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