Urethral Implantation
What is Urethral implantation ?
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Why do you need Urethral implantation ?
- urethral stent implantation
- Indicated for:
- Urethral strictures: Narrowing due to scarring (post-trauma, infection, or surgery like TURP; 1–2% risk post-TURP).
- Recurrent strictures after urethrotomy (endoscopic incision; 30–50% recurrence rate).
- Prevalence in India: Urethral strictures affect 0.6–1% of men; higher in trauma-prone populations.
- Aim: Keeps urethra open to allow urine flow; often a temporary or palliative option.
- Artificial Urinary Sphincter (AUS) Implantation:
- Indicated for:
- Severe stress urinary incontinence (SUI): Often post-prostatectomy (5–10% risk, as in your prostatectomy query) or due to sphincter damage.
- Failed conservative treatments (e.g., pelvic floor exercises, bulking agents).
- Prevalence: 5–10% of men post-radical prostatectomy develop severe SUI.
- Aim: Restores continence by mimicking sphincter function with an implantable device.
- Indicated for:
- Associated Treatments:
- Pre-op: Urethrotomy or dilation for strictures; pelvic floor therapy for incontinence.
- Post-op: Catheter for 1–3 days (stent); AUS activation at 4–6 weeks.
- Timing:
- Performed in adults (average age 40–70 years for strictures; 60–80 for incontinence); elective unless urgent (e.g., complete obstruction).
The procedures aim to restore normal urination, either by maintaining urethral patency (stent) or controlling urine flow (AUS), with high success rates but specific lifestyle adjustments.
Why Do Urethral implantation Costs Vary in Philippines?
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Urethral implantation Procedure
- Before Surgery Evaluation:
- Assessment:
- Urethral stent: Urethroscopy or retrograde urethrogram (RUG) to map stricture length/location.
- AUS: Cystoscopy to assess urethral health; urodynamics to confirm sphincter dysfunction.
- Blood tests: Blood sugar, clotting profile (infection risk higher in diabetics).
- Urine test: Ensures no active UTI (treated pre-op).
- Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotics pre-op.
- Consent: Risks, including infection, are explained.
- Assessment:
- Surgical Technique:
- Urethral Stent Implantation:
- Performed under general or spinal anesthesia, lasting 30–60 minutes.
- Process:
- Cystoscope inserted through urethra to visualize stricture.
- Stricture incised (urethrotomy) if needed; stent (e.g., UroLume or Memokath) deployed to keep urethra open.
- Stent types: Permanent (e.g., UroLume) or temporary (e.g., Memokath, removable after 6–12 months).
- Catheter placed for 1–3 days to ensure patency.
- Artificial Urinary Sphincter (AUS) Implantation:
- Performed under general anesthesia, lasting 1–2 hours.
- Process:
- Incision: Perineal (between scrotum and anus) or penoscrotal to place cuff around urethra.
- Cuff (inflatable ring) encircles urethra; pump placed in scrotum; reservoir in lower abdomen.
- System connected; cuff compresses urethra to prevent leakage; pump deflates cuff to urinate.
- Device deactivated (cuff open) for 4–6 weeks to allow healing; catheter for 1–3 days.
- Intraoperative Tools:
- Cystoscope: Guides stent placement.
- Antibiotic irrigation: Reduces infection risk (both procedures).
- Urodynamic sizers (AUS): Ensures proper cuff fit.
- Urethral Stent Implantation:
- After Surgery:
- Hospital stay: 1–2 days (stent); 2–3 days (AUS).
- Care: Catheter removed in 1–3 days; antibiotics for 5–7 days; avoid straining (both).
- Pain management: Mild pain for 3–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Stent: Monitor urine flow; AUS: Learn pump use at 4–6 weeks; avoid heavy lifting for 6 weeks.
Recovery After Urethral implantation
- Hospital Stay: 1–2 days (stent); 2–3 days (AUS).
- Post-Surgery Care:
- Pain: Mild discomfort for 3–5 days (urethral irritation or perineal for AUS); resolves in 1–2 weeks.
- Urine: Blood-tinged urine for 1–3 days (stent); catheter removal in 1–3 days; AUS: leakage until activation.
- Activity: Avoid strenuous activity for 4–6 weeks; light activities in 3–5 days.
- Device use: Stent: Immediate effect on flow; AUS: Activated at 4–6 weeks; 80–90% achieve continence.
- Incision (AUS): Perineal scar fades in 3–6 months; no external incision for stent.
- Follow-Up:
- Stent: Cystoscopy at 1–3 months to check stent position; removal (if temporary) at 6–12 months.
- AUS: Visit at 4–6 weeks (activation), 3 months (assess continence); devices last 7–10 years.
Most resume normal activities in 1–2 weeks; full recovery takes 4–6 weeks. Success rate: Stent: 70–80% symptom relief (but 20–30% stricture recurrence); AUS: 80–90% continence rate.
Risks and Complications
- Surgical Risks:
- Bleeding (1–3%): Mild hematuria; usually self-limiting.
- Infection (3–5%): Higher risk with stents (biofilm formation); may need removal.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery (Stent):
- Stent migration (2–5%): May obstruct or require repositioning/removal.
- Recurrence (20–30%): Stricture regrowth around stent; may need urethroplasty.
- Discomfort (10–20%): Foreign body sensation; may persist with permanent stents.
- Post-Surgery (AUS):
- Device erosion (1–3%): Cuff erodes into urethra; requires removal.
- Mechanical failure (5–10% at 5 years): Pump or cuff failure; needs revision surgery.
- Persistent incontinence (10–20%): Incomplete control; may need adjustments.
- Long-Term:
- Stent: Tissue ingrowth (5–10%); complicates removal.
- AUS: Infection (delayed, 1–2%); may require removal.
Report fever, severe pain, decreased urine output, or device issues promptly.
Frequently Asked Questions (FAQs)
What causes the need for urethral implantation?
Stent: Urethral strictures (scarring); AUS: Severe incontinence (post-prostatectomy, sphincter damage).
Can I avoid urethral implantation?
Yes, if mild: Stent: Urethrotomy or dilation; AUS: Pelvic exercises, bulking agents; implantation needed for severe or recurrent cases.
Is the procedure painful?
Mild discomfort for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 3–5 days; full recovery: 4–6 weeks; avoid strenuous activity for 4–6 weeks.
Is urethral implantation covered by insurance in India?
Stent: Often covered (medical necessity); AUS: Coverage varies; confirm with your provider; Ayushman Bharat may apply for stents.
Signs of complications?
Fever, severe pain, decreased urine output, or device issues.
How long do these implants last?
Stent: Temporary (6–12 months) or permanent; AUS: 7–10 years (80% functional at 5 years).
Lifestyle changes post-surgery?
Stent: Monitor urine flow, avoid trauma; AUS: Learn pump use, avoid prolonged cycling, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Urethral implantation
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.