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Urethroplasty

Hi,
I have a urethral stricture of about 4-5 centimeter long.
Doctors suggested me a Urethroplasty where they would replace tissue from my mouth.
Since i have never had any surgery done, i am worried about the risk involved and the success rate (especially in my case as they told me my stricuture is relatively longer).
Any suggestions.
Thanks
Raj
59 Responses
Avatar universal
MEDICAL PROFESSIONAL
Hi Raj,
A urethroplasty is an operation for the repair of an injury or a defect in the walls of the urethra. The method you are pertaining to utilizes tissue transfer or free graft technique. In this method, tissue is grafted from bladder epithelium, or buccal mucosa and is used to enlarge the strictured  segment of the urethra. Urethroplasty is performed under general anesthesia. Risks of Urethroplasty include: recurrence of urethral stricture, infection, fistula,  or even allergic reaction to anesthesia. Usually you meet with your doctors prior to the surgery to discuss the procedure in detail to evaluate all the benefits and risks of the procedure.  The success rate reported for Urethroplasty to treat urethral stricture is 70 - 80%. This link may be helpful: http://www.medsolution.com/surgery_urogen-urethroplasty.asp

Take care and keep us posted.
Avatar universal
Hi Raj,  I had urethroplasty surgery, on 2006.  I had several strictures, between the bulbous urethra, and the meatus.  I had a two stage surgery to fix the problem.  Unfortunately, since I was circumcised, I had no readily available donor tissue.  They used buccal mucosa tissue, to rebuild my urethra.  The first stage was to remove the damaged tissue, and graft in the buccal tissue, and left these repaired areas splayed open, to heal.  The Dr. also temporarily rerouted the exit point of the urethra, to the area beneath the scrotum.  I had to sit down to urinate, for 6 months.  When the second stage of the surgery was performed, they hooked everything back up, like normal, and rolled the repaired urethral areas around a catheter, and stitched everything back together.  Since I had a stricture at the meatus, that is the only area where I still have any issues.  The exit point is underneath the head of the penis.  During the recovery time, I had a couple stitches pull out in this area, so my exit point is about an inch back from the tip of the penis.  I must say I am happy with most of the results.  Not so happy that those stitches pulled out.  My only major issue now is the lack of sensation in the penis, during sex.  I take Cialis to help maintain an erection, but due to the amount of cutting, and stitching done, I only have sensitivity in 60 - 70% of the penis.  This leads to not always reaching ejaculation.  I just thought I would pass this info along.  Good luck with your procedure.
Avatar universal
I am going through this surgery on March 05, 2010.  What is the recovery process like?  How long did you have your cathader on your first stage?  How long before you were back to normal, I know you have to urinate sitting down for awhile.  Let me know, thanks  Raul
Avatar universal
Hello, I am getting a urethroplasty  next month and I was just wondering how the recovery process is. I am aware that I will have two catheters after the surgery for about 3 weeks and I was wondering if there will be any painful sensations to urinate or bladder spasms during the  recovery process. Thank you
Avatar universal
First, I'm laying in bed typing this 5 weeks after having urethrorplasty surgery.  I had been dealing with a sticture for 26 years, I'm not sure what caused the initial stricture.  After dealing with the issue for a couple of years taking drugs for kidney infections the narrowing became so bad that I went to see a specialist who immediately scheduled me for sugery.  Now I understand that the type of surgery I had may have caused more problems than it solved.  The surgery was done under general anesthesia and consisted of a scope with some time of blades to cut the stricture.  No catheter was installed, in fact I awakened to find a nurse telling me I couldn't go home until I had urinated.  Talking about painful, after several bags of IV fluids I couldn't hold out amy longer.  I finally relented and with assistance went into the restroom where more blood than I had ever imagined came forth along with what appeared to be major parts of my body.

I was better for about 4 years before I admitted to myself that it was happening again.  This time I had  some type a balloon procedure that hurt like heck but not like before.  The results only lasted for about a year, this started a downward spiral for the next several years.   At one point I was using a ballon catheter daily, inserting it then inflating it with a syringe full of water to inflate and open up the stricture.  I did this for a couple of years, needless to say even as carefull as I was I was plagued with multiple infections.  The catheter was placed in a pitcher filled with vinegar something my doctor ordered.  The catheter had to be reused and laste almost a year before it spung a leak.  I was instructed to use some type of persription salve which coated the catheter along with a small amount of lubricating jelly to help with insertion.

As time went along it became more and more difficult to insert and use the catheter, I was having to force it in with mutiple attemps to break through an ever increasingly tough and longer stricture.  Finally I was unable to complete the task and went in to another doctor, by this time I'd moved to another part of the country.  The new doctor inserted a very small metal rod then inserted increasing larger rods to open the stricture.  This was done in his office with only a small amount of lidocaine jelly before the procedure.  

Last year, my local specialist told me I needed to have a urethroplasty.  What?  I had heard of the procedure and can honestky say it scared the crap out of me.  I finally agreed, and went to see the specialist my specialist recommended for the procedure.

Now, here's the story.  I saw Dr. ????? in the Dallas area, was scoped the same day and scheduled for two separate procedures.  The first was done 3 days after the initial consultation where a suprapubic catheter was inserted through my pelvis into my bladder.  This is something I'd never heard of and knew nothing about.  It was installed for almost 6 weeks, these were some of the most difficult weeks of my life.  The pain was incredible, I felt as if I was being continuously stung by a wasp.  That never relented amd physically as well as mentally wore me down.

The surgery was done 5 weeks ago, they removed the suprapubic catheter during the surgery which I was greatfull for.  I had buccal muccosa removed as well as foreskin to make up the new urethra area.  The surgery lasted about 3 hours and recovery room time was an hour or so.  

First impressions after waking up, what the heck did they do to my mouth?  My tongue moved across what felt like a gaping hole inside my left cheek, that was awful and still is an issue.  I can feel the scar and continuously bite it accidentally.   The surgery gave me a large scar on a large section of my scrotum along with the accompamying stitches that fell off after about 3 weeks.  The scars and 2 separate areas of my penis has me worried as it appears that this will cause a problem with errections in the future.  

Pain, yes, yes nad heck yes.  This is dibilitating to the point where you are mentally and physically tired and sick and wonder if this is worth going through.  I go in tomorrow to have the catheter inserted in my penis tomorrow.  I hope that it will help ease  some of the pain but, the pain that will accompany the removal is worrisome to the point that I am very intimidated and honestly afraid to go.  

I guess I'm on the road to recovery, but that road seems to be very long and mostly uphill with more bumps than I'd ever imagined.  So far this is my true story.  I will post again to fill in my final anaylisis of the success or failure of the procedure.  

I hope this helps someone else...
Avatar universal
I am sorry that you had so much difficulty.  My history is poetry much the same as yours.  About 6 weeks ago I finally had Urethroplasty done.  Sure, it was difficult and scary.  The hardest part for me was having a catheter in for 3 weeks and being basically immobile.  It is amazing how slow time can go.  But, I had plenty of time to read posts like yours that scared the crap out of me.  I can now urinate great with no pain, no bleeding and my cheek is returning to normal.  My urologist told me after the surgery that he had only done 6 of these before.  Will it last?  Who knows, but so far it seems more successful than the other surgeries.  And I later found out that the other surgeries had zero percent chance of success.  I wasn't told what to expect following surgery, so the first week really surprised and concerned me.  But now that things have returned to normal (even the scar is disappearing) I am good with it.  I would absolutely have the surgery again if I had to.  Please don't scare everyone to death.  The success of this surgery is very dependant on the surgeon, taking appropriate care and precautions post-op, and having faith in God.
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