Description

Urethral Stricture Repair Urethral stricture repair is a surgical procedure to treat a narrowing of the urethra, which can cause difficulty urinating, pain, and infections. Strictures are often due to trauma, infections, previous surgeries, or inflammation. Types of Urethral Stricture Repair 1. Dilation A catheter or balloon is inserted to widen the stricture. Minimally invasive but has a high recurrence rate. 2. Direct Vision Internal Urethrotomy (DVIU) An endoscope is used to cut the scar tissue. Short recovery time, but high recurrence (30-70%) for longer strictures. 3. Open Urethroplasty (Gold Standard for Long Strictures) The scarred part of the urethra is removed or reconstructed. Types of Urethroplasty: Excision and Primary Anastomosis (EPA): The damaged section is removed, and the urethra is reconnected. Best for short strictures. Buccal Mucosal Graft (BMG) Urethroplasty: Tissue from the cheek (buccal mucosa) is used to enlarge the urethra. Preferred for long or complex strictures. 4. Perineal Urethrostomy (Last Resort) A new opening is created in the perineum to allow urination. Used for severe or recurrent strictures when other treatments fail. Indications for Surgery Weak urine stream or difficulty urinating Frequent urinary tract infections (UTIs) Urinary retention Painful urination Recurrent strictures despite previous treatments Surgical Procedure (Urethroplasty) Anesthesia: General or spinal anesthesia. Incision: Made in the perineum (area between scrotum and anus). Stricture Removal or Reconstruction: The surgeon removes the scarred portion or places a graft. Catheter Placement: A Foley catheter is inserted for 2–3 weeks to allow healing. Surgery Duration: 2–4 hours Hospital Stay: 1–3 days Post-Operative Care Catheter care (removed after 2–3 weeks) Pain management (oral painkillers) Avoid heavy lifting for 4–6 weeks Pelvic floor exercises to strengthen bladder control Follow-up visits for imaging and urine flow tests Potential Complications Stricture recurrence (lower risk with urethroplasty) Urinary incontinence (rare) Erectile dysfunction (temporary in some cases) Infections Bleeding or scarring

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