Urethral reconstruction surgery (urethroplasty) in Turkey: procedure and cost

Why consider urethroplasty?

Urethroplasty addresses urethral narrowing, or stricture. The causes vary depending on each patient's situation.

• Inflammation and infection of the urethra: urethritis or lichen sclerosus can cause scar tissue that gradually narrows the urethra.
• Trauma: accidents or direct injury can damage the urethra and need surgical repair.
• Previous procedures: catheterization, endoscopic surgery or other operations can leave scars that restrict urine flow.
• Congenital malformations: certain urethral abnormalities present from birth may benefit from surgical correction.
• Unknown cause: in some patients, no cause is found.

The aim of the operation is to restore urine flow and relieve the symptoms linked to the stricture. Many patients notice an improvement in their urinary symptoms after the procedure.

Diagnosis of urethral stricture in Turkey

Diagnosing a urethral stricture starts with a careful clinical assessment. Your urologist will review your symptoms and medical background before ordering tests.

Several imaging procedures help confirm the diagnosis:

• Urethroscopy and cystoscopy provide direct visualization. The surgeon examines the urethra and bladder to pinpoint exactly where the narrowing occurs.
• Retrograde urethrography shows the urethral caliber in detail. Ultrasound may also assess tissues surrounding the urethra.

These tests serve a dual purpose: they confirm the stricture diagnosis and rule out other conditions that might cause similar symptoms. This information guides the treatment plan.

Different urethroplasty techniques

The choice of technique depends on several variables: the cause of the stricture, its length and location, and your overall health.

The main surgical approaches include:

• Excision and end-to-end anastomosis: for short strictures, the narrowed segment is removed and the two healthy ends of the urethra are joined.
• Buccal mucosa graft urethroplasty: tissue from inside your cheek is harvested and grafted to widen the narrowed section. Buccal mucosa is widely used because it heals well in the urethra.
• Penile skin flap or graft urethroplasty: skin from the penis is used to reconstruct the urethra, particularly for strictures in the penile portion.
• Staged urethroplasty: for complex strictures, the repair is done in two operations.

Procedure for urethral stricture surgery in Turkey

Before surgery, you undergo a comprehensive health assessment. Specific tests clarify the exact nature of your stricture.

The operation is performed under general anesthesia. Your surgeon makes an incision to reach the narrowed urethral segment and frees the tissue. Depending on the technique, the narrowed segment is removed and the ends joined, or healthy tissue from another area, such as the inside of the cheek, is used as a graft to widen the urethra.

At the end of the operation, a urinary catheter is placed. A suprapubic catheter, which drains urine through the lower abdomen, is sometimes added. The catheters let urine drain while the tissues heal.

Length of hospital stay and postoperative period

Most patients stay in hospital for 2 to 3 days following urethroplasty. During this time, nursing staff monitor your recovery and manage pain with medication as needed.

After discharge, medical follow-up continues. Your care team checks healing, adjusts pain management and looks for complications.

A catheter remains in place for a period set by your surgeon. Full recovery is gradual and varies between individuals. Ask your surgeon how long you should stay in Turkey before your return flight, as a check-up or catheter removal may be needed before you travel.

Postoperative recovery

Recovery looks different for each person. Early discomfort is common, though pain levels vary considerably. Medication such as acetaminophen or anti-inflammatories usually controls it effectively.

More intense pain occasionally requires stronger medication. Physical interventions like cryotherapy or thermotherapy can reduce inflammation and provide additional comfort.

Returning to normal activities takes weeks, with timelines depending on the surgical method used and your individual response. Regular medical visits allow your surgeon to assess healing and modify treatment as needed. Gradually resuming daily routines while respecting your doctor's guidance supports better outcomes.

Risks associated with urethral surgery

Like all surgical procedures, urethroplasty carries potential risks that you should understand:

• Infection during or after the procedure.
• Bleeding.
• The stricture may recur despite a successful repair.
• Urethrocutaneous fistula: an abnormal passage between the urethra and the skin.
• Urinary changes: weak stream, dribbling after urination, leakage or increased frequency.
• Sexual function may be affected (erectile difficulty, changes in ejaculation).
• Graft-related problems: poor healing or tissue loss of the graft, and numbness or tightness in the mouth after a buccal graft.
• Chronic pain after surgery.
• The need for another operation.
• Risks of general anesthesia.

Alternatives to urethral surgery

Not every urethral stricture requires surgery. Short strictures may be treated with less invasive options:

• Repeated urethral dilatation: progressively larger instruments gently stretch the narrowed section.
• Urethral stenting: a small flexible tube holds the urethra open without surgical reconstruction.
• Internal urethrotomy: using a specialized instrument, the surgeon makes a precise incision to open the narrowed area from the inside.

These options are less invasive, but they are more likely to be followed by a recurrence, particularly for long or recurrent strictures. Your urologist explains which option suits your stricture.