Urethroplasty

Types of Urethroplasty

• Excision and Primary Anastomosis (EPA): Best for short bulbar urethral strictures. The scarred segment is removed, and the healthy ends are rejoined. Long-term success rates are very high.
• Graft Urethroplasty: Uses tissue grafts (commonly buccal mucosa from the cheek) to widen narrowed areas. Buccal grafts are preferred for their durability and ease of healing.
• Penile Flap Urethroplasty: In longer strictures, a flap of penile skin is used to reconstruct the urethra. Suitable for penile urethral strictures but not recommended with certain skin diseases.
• Staged Urethroplasty: For severe or previously failed cases, the surgery is performed in two or more stages using grafts before final reconstruction.

When is Urethroplasty Recommended?

• Persistent or recurrent urethral strictures.
• Failure of repeated dilatations or VIU procedures.
• Long, complex strictures not suitable for endoscopic correction.
• When urinary retention occurs due to scarring (temporary suprapubic catheter may be placed until surgery).

Recovery and Aftercare

• Hospital stay is usually 2–3 days.
• A urinary catheter is left in place for healing and removed after follow-up tests.
• Mild pain and discomfort are expected for a few days; bladder spasms may occur but are manageable with medication.
• Return to office work in 1–2 weeks, heavy physical work after 3–4 weeks.
• Sexual activity can usually be resumed once the catheter is removed and healing is complete.

Benefits of Urethroplasty

• Restores normal urine flow and bladder function.
• Provides durable results with lower recurrence rates compared to other treatments.
• Improves quality of life by relieving urinary symptoms.
• Effective even in complex or long-standing strictures.

Risks & Considerations

As with any surgery, urethroplasty carries risks like bleeding, infection, or recurrence of stricture, though serious complications are rare when performed by an experienced urologist.