Urethroplasty is a reconstructive surgical procedure used to treat urethral stricture. It involves repairing or reconstructing the narrowed portion of the urethra to create a wider and more durable urinary passage.
It may be considered when a urethral stricture is long, recurrent, complex or unsuitable for repeated endoscopic procedures such as Optical Internal Urethrotomy (OIU).
Urethral stricture occurs when scar tissue causes the urethra to become narrowed. This can restrict the flow of urine from the bladder and may gradually worsen urinary symptoms.
Strictures can occur in different parts of the urethra and may develop due to previous injury, infection, instrumentation, catheterization, surgery or other causes.
Urethroplasty may be recommended for patients with strictures that are not suitable for simpler endoscopic treatment or when the stricture has returned after previous procedures.
The surgical technique is selected according to the location, length and characteristics of the stricture.
In selected short strictures, the scarred segment may be removed and the healthy ends of the urethra carefully joined together.
For certain longer strictures, tissue from the inside of the cheek, known as buccal mucosa, may be used as a graft to reconstruct and widen the urethra.
More complex strictures may require individualized reconstructive techniques depending on the location, extent of scarring and condition of the surrounding tissues.
Urethroplasty is performed under anesthesia. The surgeon accesses the narrowed portion of the urethra and repairs or reconstructs the affected segment using the most appropriate technique.
In selected cases, a graft such as buccal mucosa may be used to create a wider urethral passage.
A urinary catheter is generally placed after surgery to allow the reconstructed urethra to heal properly.
Detailed assessment is important before reconstructive surgery. Depending on the patient's condition, evaluation may include:
Buccal mucosal grafts are commonly used in selected urethral reconstruction procedures. The tissue is taken from the inner lining of the cheek and prepared for use in repairing the narrowed urethral segment.
The suitability of this technique depends on the location and characteristics of the stricture and the patient's overall condition.
Recovery after urethroplasty varies according to the surgical technique and complexity of the reconstruction. A catheter is generally kept temporarily while the repaired urethra heals.
Follow-up is important after surgery to assess healing and urinary function. The treating urologist will provide specific instructions regarding activity, catheter care and follow-up investigations.
Urethroplasty is a reconstructive procedure and, like other surgeries, may involve potential risks such as:
OIU and urethroplasty are different approaches to treating urethral stricture. OIU is an endoscopic procedure that opens the narrowed area internally, while urethroplasty reconstructs the affected urethral segment.
The appropriate treatment depends on factors such as stricture length, location, severity, previous treatment and recurrence. A urologist can recommend the most appropriate option after detailed evaluation.
Consult Dr. Jaspreet Singh Chhabra for expert evaluation and individualized management of urethral stricture.
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