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What is Urethral Stricture Repair?
Urethral stricture is a medical condition that primarily affects men. It involves narrowing of the urethra, the tube that carries urine out of the body. A urethral stricture can develop gradually in some people, leading to straining to urinate. However, in others, it can occur suddenly without any previous discomfort. In such a situation, the stricture requires immediate medical attention.
Who needs Urethral Stricture Repair?
Urethral Stricture Repair is done in case of:
- Urethral strictures
- Congenital conditions like epispadias or hypospadias
- A Gender affirmation surgery
What are the Benefits of Urethral Stricture Repair?
- Helps relieve symptoms of urethral stricture
- Improves the urine flow which was blocked due to stricture
- High Success Rate
What is Risks in Delaying Urethral Stricture Repair?
Some people notice no symptoms of urethral stricture. However, with others, the problem with urination is the first symptom of urethral stricture. If left untreated, the following complications can arise:-
- Damage to bladder and kidney
- Urinary infections caused by obstruction of urine flow
- Poor ejaculation and infertility in men
How is Urethral Stricture Repaired?
There are various treatment options for urethral stricture, which include:-
- Urethroplasty: It involves surgically correcting the narrowed or damaged section of the urethra. It also consists of the restructuring of the surrounding tissues. The recurrence of stricture after urethroplasty is pretty low.
- Urethral Dilation: This procedure is used to stretch the sides of the urethra. The surgeon inserts thin rods of increasing diameters into the urethra to stretch the narrowing without any further damage to the urethra.
- Endoscopic Urethrotomy or Urethral Reconstruction: This procedure involves inserting a thin optical device (cystoscope) into the urethra. Then the surgeon inserts special tools through the cystoscope to remove the scar tissue and clear the area of blockage. It offers a faster recovery and less risk of infection. However, there are chances of recurrence of stricture.
- A Permanent Catheter or Implanted Stent: This treatment option is feasible only if the stricture is severe and you choose not to have surgery. You can get a permanently implanted stent (artificial tube) to keep the urethra open or a permanent urethra to drain urine. However, the procedure has several advantages, including the risk of urinary tract infections and bladder irritation.
Please note that the selection of the treatment approach is based on your medical condition and your doctor’s opinion. However, doctors prefer urethroplasty over other surgical treatments.
Step 1: Your surgeon will make a cut or incision into your muscle tissue (either in your scrotum or between your scrotum or anus) to reach the urethra.
Step 2: Next, the surgeon locates the stricture and removes it.
Step 3: If the scarred section of the urethra is too long to be removed, your surgeon will harvest tissue from other parts of the body and recreate the size of the urethra.
Step 4: The incision is closed, and a catheter is placed inside the urethra.
Step 5: Finally, your surgeon will close your muscle and skin with stitches that get absorbed by your body.
What Can You Expect Before the Urethral Stricture Repair?
- Before the surgery, you’ll consult an anaesthesiologist for a pre-anaesthetic checkup.
- The doctor will ask you about your complete medical history and order an X-ray or cystoscopy to identify the length and location of the stricture.
- Once you get the clearance for the surgery, your doctor will appoint a date for surgery.
- Your healthcare provider will inform you what to eat and drink before the procedure.
- He/she will also order you to fast for 8 hours prior to the surgery.
- The doctor will then briefly explain the surgical procedure and the duration of the hospital stay. In addition, he/she will inform you about the estimated cost and insurance formalities.
- Next, you will be informed about the catheter to be placed after the surgery to drain the bladder.
What Can You Expect on the Day of Urethral Stricture Repair??
- On the day of the surgery, you’ll be asked to sign the consent formalities.
- The nursing staff will ask you to remove your jewellery and change into a hospital gown.
- Someone from the team will trim or shave the hair in the surgical site.
- Your doctor will record your last meal and give you an antibiotic with a sip of water.
- After your vitals, including heart rate, breathing, and blood pressure, are monitored, the medical team will shift you to the OT room.
What Can You Expect During the Urethral Stricture Repair Surgery?
- Once in OT, you will be made to relax on the operating table.
- The healthcare team will start an IV line in your arms for fluid, medicines, and anaesthesia.
- They will give you general anaesthesia to help you sleep throughout the procedure.
- Someone from the team will clean the surgical site with an antiseptic solution and monitor your vitals throughout the procedure.
- Next, the surgeon will make a cut or incision in the required location and repair your urethral stricture.
- After the procedure is completed, he/she will close the incision with stitches and place a catheter to empty the bladder.
What is Recovery and Post Op. Care of Urethral Stricture Repair?
Recovery at Hospital:-
- After the surgery, the team will shift you to the recovery room to monitor your vitals and anaesthesia effect.
- Once your vitals stabilise, you will be moved to the hospital ward.
- Your healthcare provider will prescribe pain medication and antibiotics.
- Depending on the surgery and your condition, you may get a discharge from the hospital within one or two days.
Recovery at Home:-
- You’ll have a catheter in your urethra for two to three weeks after the surgery to help drain your bladder.
- You may be given medications to prevent bladder spasms and stop erections.
- Your doctor will ask you to avoid driving and sitting for long periods while the catheter is placed in your urethra.
- You should avoid squatting or climbing high steps. Moreover, you should abstain from masturbation or intercourse for about six weeks after the procedure.
First Follow-Up Appointment
- After your urethral stricture repair, you’ll have an appointment with your doctor about two to three weeks after the surgery.
- The doctor will remove the sutures and the catheter during this follow-up visit.
- He/she will also perform a radiology procedure to check the repair area.
When to Consult a Doctor?
Consult your healthcare professional if you experience the following:-
- Severe pain
- Blocked catheter
- Blood on your underwear
- Drainage that looks like pus
- Incision gets opened