Urethroplasty
A urethroplasty is a surgical procedure which is performed to repair damage or scarring to the urethra, with the aim of restoring normal urine to flow.
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What is a urethroplasty?
A urethroplasty is a surgical procedure, performed by a urologist, to repair damage or scarring to the urethra to enable urine to flow freely from your bladder to the outside of your body.
Why would you have a urethroplasty?
Your urologist may recommend that you undergo a urethroplasty if you have a blockage or scarring in your urethra that makes urinating difficult.
You may need to have a urethroplasty if you have:
urethral strictures – injury, surgery, or infections can cause the urethra to narrow, resulting in a weak urine stream, difficulty starting urination, and inability to empty the bladder completely. Urethral strictures are much more common in men than in women
urethral trauma – damage to the urethra can be caused by many things, including blunt force trauma, pelvic fractures, and certain medical procedures, such as catheterisation. Symptoms can include painful urination, blood in your urine, and difficulty urinating
hypospadias – affecting men, this is a congenital condition in which the opening of the urethra is located on the underside of the penis rather than at the tip, causing difficulties with urination, and sexual function
urethral fistula - an abnormal connection between the urethra and another surface, most commonly skin, which can lead to leakage of urine and infections, and may require urethral repair
What does a urethroplasty procedure involve?
In most cases of urethroplasty, a general anaesthetic will be used, so you will be asleep throughout the procedure. How long the procedure takes varies depending on the level of repair required, but it can take anywhere from 2 to 4 hours to complete.
Your surgeon will begin by making an incision into your urethra and will remove the affected tissue. Depending on the extent of the damage, your surgeon will either join the sections on either side of the removed area together or they will rebuild the affected portion using tissue from elsewhere in your body (a graft). Tissue may be taken from the lining of your cheek or back of your lips, from the skin of the penis, vagina or labia, or from your bowel.
The type of urethroplasty you will have depends on your specific case – your consultant will guide you as to which procedure is most appropriate.
Once your surgeon has repaired your urethra, they will close the incision with dissolvable stitches. You will have a catheter fitted while your urethra heals.
Urethroplasty preparation
You must not eat or drink for at least 6 hours before your surgery. Your consultant will provide you with any other preoperative instructions, which you must follow carefully to help ensure a successful outcome.
Urethroplasty recovery
After the surgery, you’ll spend some time in the recovery room while you come around from the anaesthesia. Depending on your medical needs, you may either go home on the same day, or your surgeon will have you stay in hospital overnight for monitoring. As you’ll have had a general anaesthetic, you must have someone with you to help you make your way home.
Your consultant will ensure that you leave with any medications, such as painkillers and antibiotics, that you’ll need for a successful recovery.
2 to 3 weeks after surgery, you’ll be invited for a follow-up appointment where your consultant will check how you’re healing and review the outcome of the surgery.
What are the risks associated with urethroplasty?
Urethroplasty has a high success rate. However, as with any kind of surgery, there are some risks associated with the procedure.
Risks and complications associated with urethroplasty include:
- regrowth of scar tissue, requiring additional surgery or other procedures
- pain in the scrotum or perineum (the area between the scrotum and the anus)
- a post-void dribble requiring milking out
- erectile dysfunction in men (very rarely)
- nerve injury to your legs, feet, elbows or fingers (very rarely)
These complications are rare, especially when your recovery is closely monitored by our experienced surgeons.
Alternative treatments to urethroplasty
For some people, urethroplasty is not the most appropriate treatment option. Minimally invasive alternatives that may be more appropriate for some patients include urethral dilation and balloon dilatation with Drug-Coated Balloon (Optilume®). Your consultant will recommend which treatment is best for you.
Urethral dilation involves gently stretching the stricture using specially designed dilators. This is usually performed under local or general anaesthesia and has a quick recovery time. However, the effect of this treatment is often temporary, so treatments may need to be repeated over time.
Balloon Dilatation with Optilume is a newer treatment where, under a local or general anaesthesia, a balloon coated in medication is inserted into the urethra and inflated at the stricture site. The medication helps reduce the risk of recurrence by preventing scar tissue from reforming. Early results are showing that this treatment may offer longer-lasting relief compared to standard dilatation, reducing the need for repeated procedures.
Why choose Welbeck?
At Welbeck, our urologists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if needed to ensure you receive the best possible treatment as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
Booking a private urethroplasty
To book a urethroplasty, you must be referred by either your GP or a urologist following a consultation with them. Self-referrals are not accepted for this test. If you already have your referral, please email it to bookings.urology@onewelbeck.com, and a member of our clinical team will be in touch.
If you would like to schedule a consultation with a urologist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.