Urethroplasty 1st Stage & 2nd stage

How is Urethroplasty performed?

Many reconstructive procedures require one or two operations. Depending on the severity of the structure and its location. 

The two main types are anastomotic and substitution Urethroplasty.

1.Anastomotic Urethroplasty

This technique is suitable for short urethral strictures. Incisions are placed between the scrotum and rectum such that the urethra can then be bridged after extracting the stricture.

 A catheter is placed in the penis for 10 to 21 days. After it is removed, an X-ray image is taken to ensure that the repair performed has healed.

2.Substitution Urethroplasty

In case the structure is long, tissues can be relocated using this type of surgery. 

In severe cases, substitution repairs may be required to be done in stages. It offers good results. There are three kinds of substitution procedures are:

• Free graft

• Skin flap

• Staged

 

Free Graft

It replaces or expands a portion of the urethra using the patient's tissue e.g. the skin taken from the shaft of the penis/ tissue taken from inside the cheek. 

It requires a short hospital stay and a catheter for two to three weeks.

Skin Flap

The skin flaps from the penis are rotated to form a new portion of the urethra. It is required when the graft needs to belong, and the extent of the stricture is severe.

What care should be taken After Treatment?

Recurrent urethral strictures after surgery are possible and hence follow-up appointments are crucial to monitor the condition. 

Sometimes the surgeon may suggest an additional ureteroscopy to check the repair. Some structures that may return, may not need additional treatment. 

But if it causes obstruction, it can be treated with dilation or urethrotomy. Repeat open surgery may be needed for recurrent strictures that are severe.