Urethroplasty; It is an open repair surgery performed in cases of stenosis in the urethra, which is the channel that provides urine output, due to various reasons (trauma, infection, surgeries). Generally, if successful results cannot be obtained from endoscopic procedures for urethral stenosis, urethroplasty is performed. However, it may be necessary to resort to this method directly in cases of complete stenosis resulting from trauma.
Urethroplasty is the most successful surgical method in recurrent urethral strictures, first-time complicated strictures, and urethral ruptures (injury). The success of the surgery varies depending on the length of the stenosis, its location, mechanism of formation, the age of the patient, and accompanying diseases. The overall success rate of urethroplasty surgery is over 80%.
This is a reconstruction surgery performed in cases of urethral strictures or urethral trauma.
Urethroplasty is a surgical method that has a high success rate and provides a permanent cure for urethral strictures.
The permanent success of endoscopic methods (dilatation and urethrotomy) in the treatment of urethral stricture is low. Urethroplasty surgery (reconnection or reconstruction) is the most successful method in the permanent treatment of urethral stricture.
This varies depending on the degree of stenosis. Surgery is relatively minor in short segment stenosis. However, long-segmented urethral strictures accompanied by trauma and in which buccal mucosa grafts or scrotal and penile flaps are used are complicated cases and require major surgery.
The duration of the surgery varies depending on the location of the stenosis and the use of grafts or flaps. It can last from 2 hours to 6 hours.
Since urethroplasty surgery is performed on the skin of the perineum area between the scrotum and the anus, the scar tissue that will occur after the surgery is not visible. Rarely, the incision may be extended to the penis, but since it is made along the natural line in the midline of the penis, there will be no significant scar.
For urethral stricture, dilation and urethrotomy, which are simpler, endoscopic surgeries, are generally preferred first. However, when these treatments do not work or in complex strictures caused by trauma, urethroplasty is the gold standard treatment method.
This is a rare condition (about 10%) and usually resolves by the 12th month after surgery.
As after all surgery, reducing smoking is recommended as smoking can impair overall wound healing and reconstruction. We recommend that you avoid heavy lifting for the first month. It is also recommended that you do not do activities such as cycling or horseback riding that put pressure on the perineum, where the urethra is anatomically located, for 1-2 months. Sexual activity can again be restricted for 1 month.
This choice should be made individually for each patient. As we mentioned before, urethrotomy is a better method in uncomplicated cases where stricture is detected for the first time, while reconstruction with urethroplasty is a better method in cases where this method fails or in cases that have been complicated from the very beginning.
Recovery time usually takes 2-3 weeks. catheters are also often required during this time. During this period, intense physical activity should be avoided and care should be taken to protect the catheter.
Urethroplasty price can vary between 3000 and 12,000 dollars in Turkey. This varies depending on the location of the stenosis, the length of the segment, and whether greft will be required.
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Assoc. Prof. Dr. Arif DemirbasUrology Specialist
Assoc. Prof. Dr. Arif Demirbaş
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