Urethroplasty Explained: Causes, Procedure, and Recovery

The urethra plays a vital role in the urinary system, allowing urine to pass from the bladder out of the body. When the urethra becomes narrowed or blocked — a condition known as urethral stricture — it can cause painful symptoms, repeated infections, and difficulty in urination. Urethroplasty is a surgical procedure designed to repair or reconstruct the urethra, offering long-term relief and restoring normal urinary flow.

In this blog, we will explore what urethroplasty is, when it is needed, the different surgical approaches, and what recovery looks like.

What Is Urethroplasty?

Urethroplasty is a reconstructive surgery performed to repair a narrowing (stricture) in the urethra. Unlike temporary solutions such as dilation or urethrotomy, urethroplasty aims to permanently correct the problem by removing the scarred portion or rebuilding the urethra with tissue grafts. It is considered the gold standard treatment for long or recurrent urethral strictures.

What Causes Urethral Strictures?

A urethral stricture occurs when scar tissue develops inside the urethra, narrowing its passage. The main causes include:

Trauma or Injury

• Road traffic accidents causing pelvic fractures
• Falls or blunt injuries to the pelvic region

Medical Procedures

• Previous catheterisation
• Past surgeries involving the urethra or prostate

Infections and Inflammation

• Repeated urinary tract infections (UTIs)
• Sexually transmitted infections (STIs) in some cases

Congenital (Rare)

Some men may be born with a narrowed urethra.

Symptoms of Urethral Stricture

A narrowed urethra can cause a range of symptoms that affect quality of life:

• Weak or interrupted urine stream
• Straining or difficulty in starting urination
• Increased frequency or urgency to pass urine
• Pain or burning sensation while urinating
• Recurrent urinary tract infections
• Incomplete emptying of the bladder
• In severe cases, complete urinary retention

When Is Urethroplasty Recommended?

Urethroplasty is usually recommended when:

• The stricture is long or recurrent
• Less invasive procedures (dilation or internal urethrotomy) have failed
• The patient has severe symptoms affecting daily life
• Complications such as infections or bladder damage have developed

Your urologist will determine the best approach after assessing the length, location, and cause of the stricture.

Types of Urethroplasty

There are several surgical techniques, and the choice depends on the complexity of the stricture.

Excision and Primary Anastomosis (EPA)

• Suitable for short strictures (usually less than 2 cm)
• The scarred section of the urethra is removed, and the healthy ends are joined together.

Augmentation Urethroplasty

• Used for longer strictures.
• A graft (commonly taken from the inner cheek, known as a buccal mucosal graft) is used to enlarge or rebuild the urethral passage.

Substitution Urethroplasty

• In very complex cases, tissue from other parts of the body may be used to reconstruct the urethra.

How Is the Surgery Performed?

Urethroplasty is performed under general or regional anaesthesia. The steps generally include:

1. Accessing the urethra through a small incision in the perineum (area between the scrotum and anus).
2. Identifying and removing scar tissue or preparing the narrowed area.
3. Reconnecting healthy urethral ends or using a graft to widen the passage.
4. Placing a catheter to allow healing and ensure proper urine drainage.

The surgery can take 2–4 hours, depending on the complexity of the stricture.

Take the First Step Towards Better Urinary Health with Dr. Aditya Sharma

Urethral strictures can cause significant discomfort and impact everyday life. Urethroplasty offers a permanent solution, helping patients regain normal urinary function and confidence.

Dr. Aditya Sharma, an experienced urologist, specialises in advanced urethral reconstructive surgery. With a focus on precision, patient safety, and long-term outcomes, he provides personalised care for patients dealing with urethral strictures.

Book your consultation with Dr. Aditya Sharma today and explore the most effective treatment options for urethral stricture.