Urethroplasty

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How to treat urethral strictures?

A variety of operations are now available to treat urethral strictures. Different surgical techniques are indicated according to the position, length and nature of the stricture.

Which surgical procedures are available for the treatment of urethral strictures?

Direct vision optical urethrotomy is the most commonly performed procedure in patients with urethral stricture.

Under anaesthetic, a camera is introduced in the urethral cavity and it is advanced until the stricture point. The scar tissue of the stricture is then cut open with a small penknife until and adequate urethral widening has been obtained. The main limitation of direct vision optical urethrotomy is that in most cases the strictures recur after a few months and therefore this procedure should be offered only in case of very short urethral strictures.

Urethroplasty represents the only valuable long-term solution for urethral strictures. It represents a delicate specialistic procedure that involves the removal and/or the replacement of the narrow segment of the urethra. In expert hands, long-term success rate of urethroplasty is very encouraging.

In some cases the narrow segment of bulbar urethra is severely scarred and therefore needs to be removed completely. If the segment is short, the two urethral stumps can be reconnected directly. This procedure is also known as end-to-end anastomosis. 

When the removed narrow segment of bulbar urethra is too long, the two ends cannot be reconnected directly and the urethra needs to be widened with the use of a buccal mucosa graft, which is harvested from the inner cheek. If the bulbar urethra is not scarred, no segment needs to be excised and the urethra can be simply widened with the use of a buccal mucosa graft.

If the stricture involves the penile urethra, the reconstruction should always require the use of a buccal mucosa graft and can be performed in one or two stages, according to the type of stricture.

Once the buccal mucosa graft has been harvested, the cheek heals extremely quickly. 

When to seek help

If you are straining or spraying when passing urine, you are suffering from recurrent urinary tract infections or you have persistent urine dribbling, chances are that you may have a urethral stricture.

If you experience any of these symptoms, you should book a consultation with a Specialist, as untreated lower urinary symptoms may lead to irreversible kidney damage.  After a thorough assessment, Mr Garaffa will exclude any other possible cause of your symptoms and identify the location and length of your urethra stricture. Once a urethral stricture is confirmed, you will be fully counselled regarding the various treatment options and their long-term success rate. Mr Garaffa has a very large experience in complex penile and urethral reconstruction and will be able to offer you the most advanced techniques of urethroplasty to guarantee a long-term solution to your symptoms. 

Why Choose Giulio

Giulio is a veteran surgeon with 15 years of experience in the field of Andrology and Reconstruction. He is also one of the largest penile prosthesis implanters in Europe, as well as the surgeon who performs the largest number of procedures for the correction of complex cases of Peyronie's disease. He has been invited to lecture and perform surgery in 21 different countries, in 6 different continents.

130

Penile prosthesis implants last year

300

Complex Andrological procedures every year

700

Phalloplasties over his career