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Urethroplasty

Urethroplasty is the open reconstruction of Urethral stricture. It can be done by various techniques

  • If a segment of urethra is completely scarred and lumen is obliterated then urethra is transected, both end freshened spatulated and re attached. This procedure is known as excision and primary Anastomosis.
  • If the lumen is there or stricture is long, tissue can be transferred to augment and therefore widen the narrow segment to normal caliber. Tissue can be penile skin, buccal mucosa or any extra genital skin. This procedure is known as augmentation urethroplasty
  • If urethra is densely scarred with very narrow lumen and long stricture then repair can be done in two stages. In the first stage urethra is laid open and grafting is done at the base followed by tube formation 6 to 8 months after first surgery.

The choice of repair is individual and influenced by the length and location of the stricture, the availability of local tissue, and many other factors.

Post operative phase

Subsequent to surgery patient stays in the hospital for 2 to 3 days. Patient is allowed to move around from post op day 1. Dressing is changed on 2nd post op day and patient is discharged. If buccal mucosa is harvested from cheek then oral wound take 7 to 10 days to heal. Patient is advised to take non spicy food at room temperature and mouth wash twice daily. Patient is also advised to do physiotherapy of cheek for faster recovery.

A urinary catheter is kept for 21 to 28 days (3 to 4 weeks) for healing of urethral lumen. A dye study or voiding cystourethrogram/pericatheter urethrogram is done before removal of catheter.

Follow up period

We advice patient to come for follow up at one month, 3 months, 6 months and if possible at 1 year. During every visit urine routine examination, ultrasound of bladder to check for residual urine and uroflowmetry is done. At 6 months we do a cystourethroscopy to check for the caliber of urethra. This is aimed at satisfaction of the patient. After one year we call patients for follow-up every year or in between if they develop any urinary symptoms.

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