Urethroplasty is a type of surgery to treat a narrowing (stricture) of the urethra. In men, the urethra transports urine from the bladder out of the body through the penis. It also carries sperm from the testicles, seminal vesicles, and prostate gland through the penis. The urethra may have a stricture that blocks the usual flow of urine. As a result, urine can back up in the kidneys and the tubes (called ureters) that move urine from the kidneys to the bladder. This can lead to infection and kidney damage. Urethroplasty can be used to treat a stricture if less invasive treatments don’t work or are not right for you.
Preparing for surgery
Prepare for the surgery as you’ve been instructed. In addition:
• Inform your doctor about all medicines you take. This includes prescription medicines and over-the-counter medicines, vitamins, herbs, and other supplements. It also consists of any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You might need to stop taking some or all of them before surgery.
• Follow any directions you are given for not eating or drinking before the surgical procedure. This includes coffee, water, gum, and mints. (If you have been directed to take medicines, take them with a small sip of water.)
The day of surgery
The surgery takes about 3 to 6 hours. Afterward, you will remain in the hospital for 1 to 3 nights.
Before the surgery begins:
• An IV (intravenous) line is put in a vein in your arm or hand. This supplies fluids and medicine (such as antibiotics).
• You may be given a medicine to prevent blood clots.
• To keep you pain-free in the course of the surgery, you’re given general anesthesia. This medicine puts you in a deep sleep through the surgical procedure. A tube may be inserted into your throat to aid you breathe.
During the surgery:
• Incisions are made near the region that needs to be repaired. This can be in the skin between the scrotum and anus. This can also be on the penis.
• The technique used to repair the stricture is chosen based on the location and length of the stricture.
• Foremost, the stricture is cut out. The remaining ends of the urethra may then be sewn together or the urethra may be fixed with skin and tissue gotten from another part of the body like the inside of your mouth.
• In some cases, more than one surgery may be required to repair the urethra. This is known as two-stage repair. Your doctor can tell you more.
• When the surgery is finished, the skin incisions are closed with stitches.
• A thin tube (Foley catheter) is positioned into your bladder. Another thin tube (suprapubic catheter) can be placed through a small incision in your belly (abdomen), into your bladder. These tubes assist drain urine until healing is complete.
Recovering in the hospital
After the surgery, you will be moved to a recovery room. Here, you’ll wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat might be painful at first. When you are set, you will be taken to your hospital room. While in the hospital:
• You will be given medication to reduce the pain. Let your providers know if your pain is not controlled.
• As soon as you’re able, you’ll get up and walk.
• You’ll be taught coughing and breathing practices to help keep your lungs clear and prevent pneumonia.
Recovering at home
You will be released to an adult family member or friend after your hospital stay. Have someone stay with you for the next few days to take care of you. Recovery time varies for each person. Your doctor will let you when you can go back to your normal activity. Until then, adhere to the instructions you have been given. Make sure to:
• Take all medicines as directed.
• Care for your incisions as directed.
• Care for your catheters as directed. Make sure nothing pulls on the catheters (such as clothing).
• Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that make the incision to be covered with water until the doctor says it’s OK.
• Not do any heavy lifting and strenuous activities as instructed.
• Not have sex for 4 to 6 weeks.
• Not drive until your doctor says it’s OK. Don’t drive if you’re taking medicine that make you drowsy or sleepy.
• Wear a jockstrap for support as directed.
• Walk a few times daily. Gradually increase your pace as you feel able.
• Not strain to pass stool. If required, take stool softeners as directed by your doctor.
• Drink plenty of water. This prevents urine odor and dehydration. And follow any other diet instructions you’re given.
When should I call my doctor?
Call your doctor right away if you experience any of these symptoms:
• Fever of 100.4°F (38.0°C) or higher, or as directed by your doctor
• Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage
• Pain that cannot be controlled with medicines
• Increased bruising or enlargement of the penis or genital area
• Problems with the catheters
• Trouble urinating or no urine from your catheters for fours hours
• Bloody urine with clots
• Nausea or vomiting that doesn’t go away
• Pain or swelling in your legs
You’ll have follow-up visits so your doctor can check how well you’re recovering. Catheters will likely be taken out after 2 to 3 weeks. If you have stitches that need to be taken out, this will happen within 14 days. Tests may be performed to make sure the stricture was repaired correctly and has healed well. And you may need more tests or procedures to ensure there are no problems after surgery.
Risks and complications
Risks and possible complications include:
• Bleeding (you may need a blood transfusion)
• Blood clots
• Failure to repair the stricture or the stricture comes back
• Urine leakage at the repair site
• Scarring of the urethra
• Problems passing urine
• Change in appearance of the penis
• Change in ability to ejaculate or have an erection
• Risks of anesthesia (the anesthesiologist will discuss these with you)
Disclaimer: The information provided herein is for patient general knowledge only and should not be used during any medical emergency, diagnosis or treatment of any medical condition. Duplication for personal and commercial use must be authorized in writing by Surjen.com.