Urethroplasty
What is Urethroplasty ?
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Why do you need Urethroplasty ?
Urethroplasty is indicated for:
- Urethral strictures:
- Narrowing due to trauma (e.g., pelvic fracture), infection, prior surgery (e.g., TURP, 1–2% risk as in your query), or catheterization.
- Symptoms: Weak stream, urinary retention, recurrent UTIs; 0.6–1% of men affected in India.
- Recurrence after urethrotomy (endoscopic incision; 30–50% recur within 1–2 years).
- Other indications:
- Hypospadias repair (congenital defect; urethra opens on underside of penis; often corrected in childhood).
- Urethral fistula or trauma (e.g., post-accident).
- Associated treatments:
- Pre-op: Urethrotomy or dilation often tried first; stent removal if previously placed.
- Post-op: Catheter (urethral or suprapubic) for 2–4 weeks to allow healing.
- Timing:
- Performed in adults (average age 30–50 years for strictures) or children (for hypospadias); elective unless urgent (e.g., complete obstruction).
The procedure aims to restore normal urethral function, improve urine flow, and reduce complications like infections or retention, with a high success rate for long-term patency.
Why do Urethroplasty Costs Vary in Philippines?
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Urethroplasty Procedure
- Before Surgery Evaluation:
- Assessment:
- Retrograde urethrogram (RUG) or voiding cystourethrogram (VCUG): Maps stricture length, location, and severity.
- Urethroscopy: Visualizes stricture (complements your ureteroscopy query).
- Blood tests: Blood sugar (infection risk in diabetics), clotting profile.
- 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 recurrence, are explained.
- Assessment:
- Surgical Technique:
- Urethroplasty:
- Performed under general or spinal anesthesia, lasting 2–4 hours (depends on complexity).
- Types:
- Anastomotic urethroplasty: For short strictures (<2 cm, 40–50% of cases); scarred segment excised, healthy ends reconnected.
- Substitution urethroplasty: For longer strictures (>2 cm); uses graft (e.g., buccal mucosa from cheek) or flap to reconstruct urethra.
- Staged urethroplasty: For complex cases (e.g., long strictures, prior failures); urethra rebuilt in two surgeries 3–6 months apart.
- Process:
- Incision: Perineal (between scrotum and anus) or penile, depending on stricture location.
- Stricture excised (anastomotic) or opened and replaced with graft/flap (substitution).
- Urethra reconstructed with fine sutures; catheter placed to stent repair (urethral or suprapubic).
- Closure: Sutures in layers; drain (if needed) for 1–2 days.
- Intraoperative Tools:
- Urethroscope: Confirms stricture location.
- Buccal mucosa graft: Harvested from cheek (common, 80% success for substitution).
- Doppler: Ensures blood supply to flap (if used).
- Urethroplasty:
- After Surgery:
- Hospital stay: 2–4 days.
- Care: Catheter remains for 2–4 weeks; antibiotics for 7–10 days; avoid straining.
- Pain management: Moderate pain for 3–5 days (perineal or penile); managed with painkillers (e.g., paracetamol).
- Instructions: Avoid sexual activity or heavy lifting for 6–8 weeks; monitor urine output.
Recovery After Urethroplasty
- Hospital Stay: 2–4 days.
- Post-Surgery Care:
- Pain: Moderate pain for 3–5 days (incision site); resolves in 1–2 weeks.
- Urine: Catheter (urethral or suprapubic) for 2–4 weeks; mild hematuria initially; clears in 3–5 days.
- Activity: Avoid strenuous activity for 6–8 weeks; light activities in 1–2 weeks.
- Catheter removal: At 2–4 weeks; urethrogram confirms no leak before removal; temporary leakage or urgency may follow.
- Incision: Perineal or penile scar fades in 3–6 months.
- Follow-Up:
- Visits at 1 week (check healing), 2–4 weeks (catheter removal), and 3–6 months (assess outcome).
- Uroflowmetry: At 3 months to confirm improved flow (typically >15 mL/s); success rate 85–90%.
Most resume normal activities in 2–3 weeks; full recovery takes 6–8 weeks. Success rate: 85–90% long-term patency for anastomotic; 75–80% for substitution; staged procedures may reach 90% with time.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Hematoma at incision site; may resolve or need drainage.
- Infection (3–5%): Wound or UTI; treated with antibiotics; higher risk in diabetics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Urine leak (2–5%): From suture line; may need prolonged catheterization.
- Recurrence (10–20%): Stricture returns (higher with substitution); may need repeat surgery.
- Erectile dysfunction (5–10%): Temporary (resolves in 3–6 months); permanent in <1% (perineal approach).
- Fistula (1–2%): Abnormal connection to skin; may need repair.
- Long-Term:
- Urethral narrowing (5–10%): Scar tissue; may need dilation or redo urethroplasty.
- Incontinence (1–2%): Rare; usually temporary if sphincter unaffected.
Report fever, severe pain, heavy bleeding, or inability to urinate post-catheter removal promptly.
Frequently Asked Questions (FAQs)
What causes the need for urethroplasty?
Urethral strictures (trauma, infection, prior surgery), hypospadias, or trauma-related defects.
Can I avoid urethroplasty?
Yes, if mild: Urethrotomy, dilation, or stents (as in your prior query); urethroplasty needed for recurrent or severe strictures.
Is urethroplasty painful?
Moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 1–2 weeks; full recovery: 6–8 weeks; avoid strenuous activity for 6–8 weeks.
Is urethroplasty covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, heavy bleeding, or inability to urinate post-catheter removal.
Will urethroplasty affect urination or sexual function?
Urination improves (85–90% success); erectile function usually preserved (5–10% temporary issues).
Lifestyle changes post-surgery?
Avoid trauma to urethra, hydrate well, monitor for recurrence, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Urethroplasty
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.