Urethral reconstruction surgery - Uretroplasty : Process & cost in Turkey

Why consider urethroplasty?

Urethroplasty is a surgical procedure that is often recommended to treat narrowing of the urethra (stenosis). These narrowings can be caused by several things:

• Repeated urinary tract infections: These can cause scar tissue to form, narrowing the urethra.
• Trauma: Accidents or injuries can damage the urethra, requiring surgical repair.
• Previous surgery: Some surgeries can leave scars that cause narrowing.
• Congenital malformations: Present at birth, these urethral abnormalities may require surgical correction.
• Tumors: Removal of a tumor may result in a narrowing of the urethra that must be corrected.

The goal of urethroplasty is to restore normal urine flow and relieve symptoms associated with strictures.

Diagnosis of urethral stricture in Turkey

Diagnosis of urethral stricture begins with a thorough medical examination, including questioning about the patient's symptoms and medical history.

To confirm the diagnosis, the urologist will perform imaging tests, including:

• Urethroscopy and cystoscopy allow direct visualization of the urethra and bladder to determine the exact location of the narrowing.
• Retrograde urethrography provides additional information about the caliber of the urethra, while ultrasound allows assessment of surrounding organs.

These tests not only confirm the diagnosis of urethral stricture, but also help to rule out other possible causes of symptoms and plan the most appropriate treatment.

Different urethroplasty techniques

The choice of the urethroplasty technique depends on several factors, including the cause, location, and extent of the stricture, as well as the patient's overall health.

The most common urethroplasty techniques include:

• Buccal urethroplasty: A fragment of the buccal mucosa is removed and used to reconstruct the narrowed portion of the urethra. This technique is often preferred because the buccal mucosa heals well.
• Intestinal urethroplasty: In some cases, a segment of the intestine can replace the damaged part of the urethra. This option is usually considered when other techniques are not feasible.
• Penile urethroplasty: A flap of skin from the penis can be used to reconstruct the urethra, especially in cases of penile stricture.
• Skin grafting: A skin graft may cover the reconstructed portion of the urethra to ensure proper healing.

Procedure for urethral stricture surgery in Turkey

Before the operation, a complete health assessment will be carried out, including specific tests to understand the nature of your urethral stricture.

The operation, which is performed under general anesthesia, involves accessing the narrowed area of your urethra through an incision. The surgeon will then free the tube and, if necessary, reconstruct it using healthy tissue from another part of your body. This graft is carefully sutured in place to restore normal urine flow.

At the end of the procedure, a urinary catheter and a suprapubic catheter are placed to facilitate healing and ensure effective drainage.

Length of hospital stay and postoperative period

The hospital stay for urethroplasty in Turkey is 2 to 3 days, during which time the patient receives nursing care and pain relief, if necessary.

The post-operative period involves close medical follow-up to monitor healing, manage pain and prevent complications.

A temporary urinary catheter is often placed to facilitate healing.

Full recovery takes time and is gradual, depending on the individual's response to treatment.

Postoperative recovery

Recovery from urethroplasty varies from patient to patient. Some pain often marks the first few days. The intensity of the pain varies from person to person, but is usually well controlled with medication (acetaminophen, anti-inflammatories).

In more severe cases, stronger analgesics may be prescribed. Complementary techniques such as cryotherapy or thermotherapy may also provide relief and reduce inflammation.

Convalescence may take several weeks, depending on the surgical technique used and each patient's individual response. Regular check-ups allow us to monitor the healing process and adjust treatment accordingly. To optimize recovery, it is important to gradually resume daily activities while following your doctor's recommendations.

Risks associated with urethral surgery

The risks associated with urethroplasty are many and may include:

• Postoperative infection.
• Bleeding.
• Recurrence of urethral stricture.
• Urinary problems (incontinence, difficulty urinating, increased frequency).
• Sexual complications (erectile dysfunction, ejaculation).
• Specific risks associated with tissue transplantation (rejection, infection, necrosis),depend on the surgical technique used.

Alternatives to urethral surgery

Urethral strictures do not systematically require urethroplasty. For mild strictures, less invasive treatments may be considered, such as:

• Repeated urethral dilatation: This technique uses progressively larger catheters to dilate the narrowed urethra.
• Urethral stenting: A stent, a small flexible tube, is placed to keep the urethra open and help urine flow.
• Internal urethrotomy: A special instrument is used to incise the narrowing and widen the urinary tract.