STRICTURE URETHRA

A urethral stricture occurs when scarring narrows the tube that carries urine out of your body. Urethral stricture restricts the flow of urine from the bladder and can cause a variety of medical problems in the urinary tract, including inflammation or infection.

What is Urethroplasty?

Urethral stricture is a medical condition characterized by the narrowing of the urethra, the tube that carries urine from the bladder to the outside of the body. Urethroplasty is a major surgical procedure performed to correct urethral stricture.

Causes of urethral stricture may include:

• Trauma to the urethra resulting from road traffic accidents, straddle injuries, or other incidents.
• Epispadias or hypospadias, congenital conditions affecting the urethra that are present from birth.
• Previous surgical procedures involving the urethra.
• Injuries caused by catheterization.

The medical professional excises the cicatricial region from the urethra. In instances where the length of the scar tissue is minimal, the two extremities of the urethra are reconnected post excision of the scar tissue. In cases where the scar tissue is extensive, a graft harvested from the buccal mucosa (lining of the oral cavity) or another anatomical site is utilized to reconstruct the scarred segment of the urethra.

Procedure

• Initial Examination During your initial consultation, we will conduct routine blood and urine tests to evaluate kidney function, perform a urine culture, and complete a preoperative assessment. Additionally, a cystoscopy and a retrograde urethrogram (RGU) X-ray will be scheduled to precisely determine the location, length, and severity of the stricture. Dr. Raju R will take the time to address any questions or concerns you may have, thoroughly explaining the details, potential complications, and anticipated outcomes of the surgical procedure. Both the cystoscopy and RGU are brief, minimally uncomfortable procedures performed in our office.

• Day of the Procedure Kindly refrain from consuming any food or beverages for a minimum of 6 hours prior to your scheduled surgery. Please ensure that you bring all of your relevant medical records with you. An intravenous drip will be administered into your arm for the purpose of delivering pre-operative fluids and antibiotics. The anesthesiologist will conduct a thorough medical history assessment in order to determine the most appropriate type of anesthesia for your procedure.

Will I be Awake during the Procedure?

There are two primary anesthesia options for this procedure:

• General Anesthesia: You will be completely asleep during the surgery and will not retain any memory of it.
• Regional Anesthesia (e.g., Spinal or Epidural): A needle will be inserted into your back to administer medication that will numb your body from the waist down. You will be awake but sedated, and you will not experience any pain during the surgery. Please feel free to discuss these options, as well as any previous complications or health concerns, with the anesthesiologist.

After the Procedure

The surgical procedure typically spans approximately one to one and a half hours. Subsequently, you will be transferred to the postoperative recovery area with a catheter in place to facilitate optimal and expeditious healing of the reconstructed urethra. While you will be conscious, you may experience a slight feeling of disorientation due to the effects of anesthesia. During this phase, your vital signs and urine output will be closely monitored. Approximately five to six hours after the procedure, you will be transferred to your private room.

Advantages of Urethroplasty?

• Permanent Solution: Urethroplasty offers a long-term solution for urethral strictures compared to temporary measures like repeated dilatations or urethral stents. It aims to permanently widen or reconstruct the urethra, providing lasting relief from symptoms.
• Improved Urinary Function: By widening or reconstructing the urethra, urethroplasty restores proper urinary flow, reducing or eliminating symptoms such as difficulty urinating, urinary retention, weak stream, and urinary tract infections.
• Reduced Risk of Complications: Urethroplasty is associated with lower rates of complications compared to other treatments like repeated dilatations or urethral stents. Complications such as urinary tract infections, bleeding, and damage to surrounding tissues are minimized with urethroplasty.

Side Effects of Urethroplasty

• Urinary incontinence: In some cases, individuals may experience urinary incontinence following urethroplasty, particularly if the surgery involves the sphincter muscles that control urine flow. This is more common in complex cases and may be temporary or permanent, depending on the extent of the surgery and individual factors.
• Recurrence of urethral stricture: Despite successful urethroplasty, there is a risk of urethral stricture recurrence over time, requiring further treatment or repeat surgery.
• Erectile dysfunction or sexual dysfunction: Depending on the type and location of the urethroplasty, there may be a risk of erectile dysfunction or other sexual dysfunction. This risk is generally low but may occur, particularly if the surgery involves structures that affect sexual function.
• Urethral fistula: In some cases, a connection (fistula) may develop between the urethra and surrounding structures, leading to leakage of urine. This complication may require further surgical correction.

Is Urethroplasty Safe?

Overall, urethroplasty is considered a safe and effective procedure, particularly when performed by an experienced urological surgeon like Dr. Raju R in appropriate surgical settings. The success rate of urethroplasty is generally high, with many patients experiencing long-term relief of symptoms and improved urinary function.

When Urethroplasty is Needed?

• Urethral trauma sustained during road traffic accidents, straddle injuries, or other incidents.
• Congenital conditions affecting the urethra during childhood, such as epispadias or hypospadias.
• Prior surgical interventions involving the urethra.
• Injuries resulting from catheterization procedures.

What Would Disqualify Me from Urethroplasty Surgery?

• Any infection of the urinary tract.
• Medical health issues such as cardiac problems, uncontrolled hypertension, or diabetes, where anesthesia poses a life-threatening risk.

When Can I Resume Work?

We recommend that you allow 3 to 4 weeks off from work, especially if you do manual labor or lift heavy objects for a living. In general, it is safe to go back to work once the catheter is removed. If you have a desk job, however, you can probably return to work after 1 to 2 weeks. We suggest that you consider working shorter days the first week you return to work.

When Can I Resume Exercise?

You can resume strenuous exercise 4 weeks after surgery. Bicycling and horseback riding are highly discouraged.

When Can I Resume Sexual Activity?

You can begin as soon as the Foley catheter is removed. If you have any new onset problems with erections, please tell your doctor.

Why Choose Genesis Superspeciality Hospital for Stricture Urethra Management / Urethroplasty?

Genesis Superspeciality Hospital always prioritizes patient safety, comfort, and satisfaction throughout the treatment process. Dr. Raju R possesses a remarkable history of achieving successful results and holds substantial expertise in Stricture Urethra Management /Urethroplasty. With exceptional surgical outcomes and competitive pricing, our facility offers prompt surgical scheduling, minimizing patient wait times.