Urethral reconstruction is performed to repair a urethral stricture. This open surgery involves an incision on the stricture area in the penis, scrotum, or perineum. This procedure is done to reconstruct the damaged urethra caused due to prostate cancer in men. It takes three to six hours to perform the surgery. A urethral catheter is left in for two to four weeks for the newly constructed urethra tube to function properly – then it’s gently removed.
Urethroplasty surgery is performed to reconstruct urethra for normal functioning of the bladder. Men suffering from prostate cancer develop urethral strictures that causes pain and sometimes bleeding while passing urine. To correct this problem, the affected part of the urethra is removed, and the two normal ends are re-attached. A urethral catheter is left in for two to four weeks after the surgery. It’s gently removed once the bladder is X-rayed to find if the surgical site is completely healed. Subsequently, patients can resume their natural process of passing the urine.
Shorter urethral strictures – It involves removing the damaged part of the urethra and re-stitching the two normal ends. As urethra is elastic thus this surgery can be easily performed without causing any tension to the organ. This procedure is best suited for treating strictures located deep in the urethra, towards the prostate.
Longer urethral strictures – If urethra is no longer elastic, the above procedure cannot be performed. Thus, tissue need to be transferred to the urethra to widen the narrow passage to a normal size. To perform this surgery, the urethra is cut lengthwise to open it split-wide, for the urethra tube to become a strip. Then, the tissue patch is added, and the organ is stitched.
Two-stage repair method – If the above Urethral reconstruction plans fail, alternative methods like two-stage repair is available. The skin graft is stitched on the undersurface of the penis, and later converted into a new urethra during a second surgery.
Usually, patients stay overnight at the hospital after surgery. They can return home, once they can walk, eat, and care for their catheter. For successful healing, patients must refrain from strenuous exercise (jogging, running, cardio), heavy lifting, and sexual activities for two weeks. It’s advised that until the catheter is present, patients must refrain from their physical chores.
Wearing the catheter is a daunting task. However, it’s manageable and unobtrusive, if it’s attached to a small drainage bag that straps to the lower leg under a pair of pants.
The follow-up is crucial if you don’t desire a second surgery, as urethral strictures can easily recur within the first year after surgery. It involves visiting your urologist every three to six months in their first year after surgery.
The patient undergoes urethra cystoscopy to measure the urinary flow rate and residual urine. This exam is conducted by the urologist by placing a small scope inside the urethra from the penis to examine the surgical site for any newly formed strictures. The follow-up exams are based on this result.
Our skilled and board-certified team of urologic specialists manage and treat all types of urethral diseases and conditions. Based on the prognosis of urethral strictures, our doctors perform urethroplasty or urethral reconstruction surgery. Further, our post-operative medical staff ensures that the patient is completely recovered in body, mind, and soul.
Urethroplasty proves to be successful for 75-85 percent cases. If the stricture reappears, it must be very tight to cause blockage of the urinary flow. If the patients indicate symptoms, then a scope is used to make incisions in the urethra to remove the stricture. If it fails, then additional surgery is needed, which is rare.
When strictures reappear, they are usually thin and web-like. They can cause obstruction, but a scope procedure can be used to remove them. However, if they are dense and heavy scarring appears, then another open surgery is required.
Side effects include pain, infection, bleeding, and recurrent stricture. Urinary incontinence can occur if the treatment is done for prostate cancer or pelvic fracture. Often, erectile dysfunction is witnessed among men, and further surgeries may be needed to rectify it.
Once the catheter is removed, patients can resume work, but only lighter chores are recommended until eight weeks after the surgery.
Urethroplasty has indicated robust long-term results. However, the results depend on the severity of the pelvic trauma and the skills of your surgeon. Research indicates a success rate of 92%-97% for reconstructing a fractured pelvic, and 70% – 85% for prostate cancer.
We provide effective surgical and non-surgical treatments for all parts of the body. At Cutis Hospital, our cosmetic and plastic surgery team is committed to giving patients safe and high-quality care.
