English
Urethroplasty Surgery in Bhubaneswar

All Techniques of Urethroplasty

Urethroplasty Surgery in Bhubaneswar

Urethroplasty is a medical procedure that involves the replacement or restoration of the urethra, typically due to obstructions caused by scarring, trauma, or innate deformities. After excising scar tissue, surgeons join the ends of the urethra or use tissue grafts from other parts of the body to repair the affected ureter. In situations where the urethra becomes narrowed and obstructs the passage of urine, a procedure called Urethroplasty is frequently required. Urethroplasty surgery in Bhubaneswar is also commonly used to treat congenital defects such as epispadias or hypospadias, especially in reconstructed urethras. In the field of genitourinary medicine, the correction of congenital abnormalities or blockages in the urethra, known as Urethroplasty, presents unique difficulties. However, advancements in techniques and modifications have shown promising results and efficient functioning post-surgery. Various methods have been investigated in the treatment of transgender men, such as using skin flaps from the genital area, transferring mucosal tissue from the bladder, and addressing radiation-induced urethral strictures. Also, progress in tissue engineering and innovative tissue transfer techniques offers the potential for successful restoration of the urethral appearance and function.

FAQ's

Urethroplasty can be done in a variety of ways, including:

  • Anastomotic Urethroplasty, or Excision and Primary Anastomosis (EPA) Urethroplasty 
  • Graft Urethroplasty
  • Penile Flap Urethroplasty
  • Staged Urethroplasty 
  • Tissue Engineering
     

The most successful way to permanently treat small bulbar urethral strictures is by performing an End-to-End Anastomosis (EPA), where the two ends are removed and reconnected. To preserve blood flow to the proximal area of the urethra, a non-transecting approach was developed. This involves cutting a portion of the bulbar urethra between the prostate and scrotum and then making an incision between the scrotum and the anus. The two severed ends of the urethra are then stitched together. EPA is a preferred option for strictures close to the prostate, deep within the urethra, and of short length.
 

Penile Skin Flap Urethroplasty is an effective technique for repairing an affected urethra, specifically from the navicular fossa to the membranous urethra. While it was originally used to reconstruct a missing urethra in cases of posterior hypospadias, it has now been found to also effectively treat urethral strictures.

This method is used when managing a narrowed ureter that requires more than two treatments. A two-stage process, known as Staged or Johanson's Urethroplasty, is used and involves two phases.

Step 1: Create a cut on the underside of the penis to accommodate the narrow passage. Once removed, a tissue graft crafted from the inner cheek is used to repair the injured area. After two weeks, the catheter and bandage are removed and a bolster dressing is applied. Detailed instructions are given to patients on how to properly care for the surgical area, including replacing dressings and performing stretching exercises.

Stage 2 (three months later): The transplant constructs a pathway for easy urination at the tip of the penis. The catheter was removed after a few weeks to aid in recovery. Generally, this is an outpatient surgery.
 

Tissue Engineering Urethral Reconstruction uses engineered tissues or biomaterials to repair or replace damaged segments of the urethra. This innovative approach involves creating scaffolds that are infused with cells to promote tissue regrowth, improve compatibility, and achieve lasting outcomes. This method offers a potential alternative for challenging situations where traditional grafts or flaps are inadequate.
 

The following are some of the benefits of a Genital Skin Flap for Urethral Reconstruction:

  • Flexible enough to be used with any type of anterior urethral repair.
  • The external pudendal artery's abundant blood supply guarantees life even in adverse circumstances.
  • Can be raised to any urethral segment using a pedicle of enough length.
  • The urethra's proximity makes single-procedure repair possible.
  • Hairless, flexible, thin, and strong enough to withstand repeated urine contact.
  • There is little scarring because of the organic incision lines.
  • Can be carried out under regional anaesthesia, preventing complications from general anaesthesia.
     

Although Urethroplasty has a high success rate, problems might arise, particularly with complex and lengthy strictures. Only a small percentage of patients encounter severe issues. Among the complications are:

  • The stricture recurring
  • Infection
  • Urinary incontinence, which gets better with regular exercise
  • Retention of urine requiring catheterisation
  • Distortions in ejaculation and retrograde ejaculation 
  • Loss of penile feeling 
  • Erectile dysfunction
  • Referred Pain 
  • Urinary urgency  
  • Urinary fistula
  • Sprinkling urine
  • Haematoma
  • Bleeding externally (from suture lines)
  • Internal bleeding (discharge of blood from the urethra)
     

Alternative methods for addressing issues with the urethra include: 

  • Implementing regular, intermittent catheterisation
  • Utilising a persistent suprapubic tube
  • Undergoing a perineal urethrostomy procedure
  • Receiving endoscopic treatment such as Urethral Dilation or Direct Vision Internal Urethrotomy

While your catheter is in place, it's recommended that you refrain from driving and sitting for extended periods. You should also avoid activities like crouching or spreading your legs widely. However, you can still walk and climb the stairs as usual. Your excised area is expected to recover rapidly, and new tissue should replace the excised tissue within three weeks.
 

Home Bhubaneswar Specialities Urology All-techniques-of-urethroplasty-2

Appointment
Health Check
Contact Us
review icon
Review Us
Call Us