Urethroplasty
Urethroplasty is a surgical procedure performed to treat urethral stricture, a condition where the urethra (the tube that carries urine from the bladder out of the body) becomes narrowed or blocked due to scarring, injury, infection, or previous surgeries.
During urethroplasty, the damaged portion of the urethra is repaired or replaced using tissue from the patient’s own body — commonly taken from the inner cheek (buccal mucosa) or nearby skin. This reconstructive technique helps restore normal urine flow, prevent recurrent infections, and improve bladder emptying.
It is considered the most durable and successful treatment for urethral stricture, with long-term results far superior to repeated dilatations or internal urethrotomy (VIU).
Indications
- Recurrent urethral strictures not responding to dilation or VIU
- Traumatic urethral injuries
- Congenital narrowing or post-infectious strictures
- Strictures caused by catheterization or previous surgery
- Failed endoscopic treatments
Types of Urethroplasty
- Excision and Primary Anastomosis: The narrowed segment is removed and the healthy ends are rejoined.
- Substitution Urethroplasty: The stricture is widened using buccal mucosa (inner cheek) or skin graft.
- Augmented Urethroplasty: A graft or flap is added to enlarge the urethra while preserving existing tissue.
Procedure Steps
- Anesthesia: Performed under general or spinal anesthesia.
- Exposure: The affected part of the urethra is carefully exposed.
- Repair: The scarred segment is excised or reconstructed using grafts.
- Catheter Placement: A urinary catheter is left in place for 2–3 weeks to allow healing.
- Follow-up: Imaging is done before catheter removal to ensure proper urethral healing.
Advantages of Urethroplasty
- Permanent solution for urethral stricture
- Restores normal urine flow
- Prevents recurrent infections and bladder problems
- Improves quality of life
- High long-term success rate (over 90%)
