Urethroplasty
What is urethroplasty?
Urethroplasty is a surgical procedure done on the urethra, which is a component of the urinary system. The urethra is the tube that transports pee from your urinary bladder to the exterior of your body. In males, the urethra also transports sperm outside of the body.
Why is urethroplasty performed?
Urethroplasty is a procedure used to repair or replace the urethra when scar tissue grows within it. After removing the scar tissue, your surgeon joins the two ends of your urethra or may use tissue from another part of your body to repair the blocked piece of your urethra.
You may need urethroplasty if you have a urethral stricture. This signifies that a portion of your urethra has narrowed, preventing urine from flowing. Urinary strictures are much more prevalent in males than in women.
You have epispadias or hypospadias, which are congenital urethral disorders that were treated during your youth. Blockages are more prevalent in urethras that have already been repaired.
You’ve had reconstructive surgery.
Is urethroplasty considered a serious surgery?
The duration of surgery is determined by the amount of corrective work required. For example, a repair that connects two ends of your urethra takes less time than one that involves tissue from another part of your body. If your whole urethra is affected, many pieces of tissue may be required to reconstruct it.
Common tissues utilized to repair urethras include the mouth, cheek lining, and back of the lips. This is known as the buccal mucosa.
Your genitalia. If you have a penis, your surgeon may use skin from it. If you are undergoing reconstructive surgery, your surgeon may utilize skin from your vagina or labia.
Your rectum is surgically accessed via your anus while you are unconscious.
Procedure Details
What occurs before the urethroplasty?
An X-ray known as a retrograde urethrogram, or cystoscopy, is used to determine the length and location of the obstruction. Both are short and painless procedures performed at your healthcare provider’s office. Before the operation, your healthcare professional will give you instructions on what and when you may eat and drink, as well as what to do with any medicines you are taking.
Your doctor may recommend that you have a suprapubic catheter implanted before surgery to enable your bladder to empty and your urethra to “rest” so that scar tissue may announce itself (and therefore be corrected) before to surgery. This is often indicated if you need self-catheterization to keep the blockage open. These catheters are inserted directly into the bladder via the pubic region (just above the pubic bone).
You will remove your jewelry, change into a hospital gown, and then go to the surgery room. You will be given general anesthetic to induce a deep slumber.
What occurs during urethroplasty?
To access your urethra, your surgeon will make an incision in your muscular tissue. The incision is usually made on the underside of your penis, in your scrotum, or (more often) between your scrotum and anus (perineum). The stricture is detected and either eliminated or reconstructed based on its length and placement.
If the obstruction is lengthier or placed in the penile urethra, the surgeon will collect tissue from your mouth, genitals, or rectals to replace the urethral tissue that has been incised (cut away). The incision is then closed, and often a little drain is put for a day or two. You’ll be given a catheter to let the urethra to heal while pee continues to flow out of your body. Your muscle and skin will be stitched up using sutures that are absorbed by your body; you will not need to have them removed.
What occurs after a urethroplasty?
You will spend some time in the recovery room while you come out of anesthesia. If you undergo urethroplasty as an outpatient operation, you will need someone to drive you home. Most patients return home the same day or spend one night in the hospital. You’ll be given a urinary catheter, pain relievers, antibiotics, and potentially a bladder spasm prevention drug. You may also be given medicine to prevent you from experiencing erections. If tissue from your mouth is used to rebuild your urethra, you may need a specific mouthwash to keep the region clean.
You will have an appointment with your healthcare practitioner around two to three weeks following your urethral repair surgery. If you haven’t had one previously, you may be scheduled for a radiological treatment to assess the region of repair. If you require the procedure, the radiologist will inject contrast into your bladder, remove the catheter, and take X-rays while you pee. You will next meet with your clinical team, who will evaluate the photographs.
Risks / Benefits
What are the benefits of urethroplasty?
According to research, urethroplasty is the most effective treatment for urethral strictures and allows urine to flow freely. The success rate is rather high, at around 80%. In certain circumstances, depending on location and duration, the success rate is consistently more than 90%.
What are the risks and dangers of urethroplasty?
Every operation has dangers, including anesthetic issues and the possibility of infections.
You can have catheter leaking or obstruction. To alter your catheter, you’ll need to consult a specialist. In addition, you may develop an infection in your urine or wound during or shortly after placing your catheter.
The biggest danger or problem is that urethroplasty may not function in the long run and may need further treatments, such as an interior cutting surgery to remove scar tissue. This is one reason why you should attend your follow-up visits.
Other rare dangers include:
Nerve damage to the legs, feet, elbows, or fingers as a result of the surgical posture.
Pain in the scrotum or perineum (the region between the scrotum and the anus) caused by nerve injury.
Urine or sperm leaking or seeping from your penis due to collection in the surgical region.
Erectile Dysfunction. If this happens, it is usually short-lived, lasting no more than 18 months.