What is Urethroplasty?

Urethroplasty is a surgical procedure to repair or reconstruct the urethra, primarily used to treat urethral strictures (narrowing of the urethra) that cause urinary obstruction.

Unlike minimally invasive procedures such as VIU or OIU, urethroplasty is recommended for long, recurrent, or complex strictures, offering a permanent and durable solution. The procedure restores normal urine flow, prevents recurrent infections, and improves quality of life.

Causes of Urethral Stricture

Urethral strictures can occur due to:

• Trauma or injury to the urethra (e.g., accidents, catheterization)

• Chronic infections or untreated urinary tract infections (UTIs)

• Previous surgeries in the urinary tract

• Inflammatory conditions, such as lichen sclerosus

• Congenital defects present from birth

Symptoms of Urethral Stricture

Patients who may need urethroplasty often experience:

• Weak or slow urine stream

• Difficulty starting urination

• Incomplete bladder emptying

• Urinary urgency or frequent urination

• Dribbling after urination

• Pain or burning sensation while urinating

• Recurrent urinary tract infections

When is Urethroplasty Recommended?

Dr. Swapnil Gholap may recommend urethroplasty if:

• The stricture is long (>1.5–2 cm) or complex

• Previous minimally invasive procedures (VIU/OIU) have failed

• Recurrent urinary obstruction or infections occur

• The patient experiences persistent urinary symptoms affecting daily life

• A permanent and durable repair is preferred

The Urethroplasty Procedure

• Anesthesia – The surgery is performed under general or spinal anesthesia.

• Stricture excision or reconstruction – The scarred segment of the urethra is removed, and healthy tissue is reconnected, or a tissue graft (from the mouth or other areas) is used to reconstruct the urethra.

• Catheter placement – A urinary catheter is placed to allow healing of the reconstructed urethra.

• Hospital stay – Patients typically stay 2–5 days depending on the complexity of the surgery.

• Follow-up – Catheter removal and imaging tests ensure proper healing and normal urine flow.

Recovery & Aftercare

• Catheter care – The catheter remains for 2–3 weeks to maintain the urethral opening.

• Hydration – Drink plenty of fluids to prevent infection and promote healing.

• Activity – Avoid heavy lifting or strenuous activities for 3–4 weeks.

• Follow-up visits – Regular checkups and uroflowmetry confirm successful repair.

• Long-term monitoring – Ensures no recurrence of stricture and maintains urinary function.

FAQs About Urethroplasty

1. Is urethroplasty painful?
The procedure is performed under anesthesia. Mild discomfort or burning may occur post-surgery but is manageable with medication.

2. How long is recovery after urethroplasty?
Most patients resume normal activities within 3–4 weeks, with full recovery around 6–8 weeks, depending on the extent of reconstruction.

3. Can strictures recur after urethroplasty?
Recurrence is rare after urethroplasty, making it a long-lasting solution compared to minimally invasive procedures.

4. Will urethroplasty affect sexual function?
Most patients maintain normal sexual function. The surgeon takes care to preserve surrounding nerves and tissues.

5. How effective is urethroplasty compared to VIU/OIU?
Urethroplasty is more effective for long, recurrent, or complex strictures, with significantly higher success and lower recurrence rates than endoscopic procedures.