Urethroplasty
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Trauma to the penis or a sexually transmitted disease can cause scar tissue to build up in the channel where urine passes. At UVA Health, you'll find experts who can remove this scar tissue and restore your ability to pee again. This procedure is known as urethroplasty.
If you need this surgery, you'll be in expert hands at UVA Health. We have the skill to remove the blockage or even rebuild the urine channel in more severe cases.
After this surgery, most patients are able to go home the same day.
Urethroplasty Procedure
Before the Procedure
Our urology team takes an X-ray of your urethra to locate the scar tissue. We may also evaluate your urinary track through a uroflow test (to measure the flow and force of your urine) or cystoscopy.
Removing Scar Tissue from the Urethra
Scar tissue can block the flow of urine. At UVA, you can find relief with a urethroplasty. This removes or moves the tissue to enlarge the urine channel. Urologist Nicolas Ortiz, MD, explains the procedure and recovery process.
Nicolas Ortiz, MD:
Urethroplasty is the reconstruction of the urethra due to traumatic injury and sometimes from sexually transmitted diseases. Patients are able to undergo reconstruction and go home the same day. They usually do have a catheter that needs to stay in for a few weeks. But after this, they usually have a high success rate and they're able to void on their own. Urethroplasty, depending on whether we just do a removal of the scar versus the use of a graft to reconstruct the urethra, can take as little as 90 minutes and sometimes it can take up to four or five hours in the more complex cases. Recovery from urethroplasty usually takes three to four weeks. They usually get to go home the same day after surgery. The pain is generally well controlled. Most of the time they return to our clinic and we remove the catheter after doing an imaging test to ensure that the area has healed. And after that, the catheter comes out and they have generally no other restrictions.
After the Procedure
You can expect to stay in the hospital for 1-2 days after surgery. You'll have a small tube called a catheter inside you for 10-20 days so the area can drain as it heals. It's normal for urine to leak around the catheter, especially during bowel movements.
If you notice your catheter isn't draining, change positions and drink more fluid. If this doesn't help, contact your care team.
Your care team will show you how to keep the catheter clean and tape it to the skin so it doesn't move. Use antibiotic ointment at the penis opening daily to keep the catheter from sticking.
You may experience mild pain, scrotal swelling and minor bleeding. Treat this by:
- Wearing a jock strap or tight underwear
- Taking over-the-counter pain medication. Your doctor may also prescribe medication.
- Using an ice pack
- Avoiding sex
- Wearing gauze over your dressing
- Sitting in a bath with water up to your hips beginning a week after surgery
Will I Have a Scar?
Most procedures are performed through the perineum, the region between the scrotum and the penis. In some cases, it's necessary to cut the penis to use skin from it. Rarely, this can leave scar tissue on the outside of the penis.
Resuming Activities
Limit your activity for at least two weeks or until after your catheter is removed. You may return to work when you feel comfortable, but limit heavy lifting or any extended walking and running.
You may begin to shower 48-72 hours after surgery. You can get your incision wet, but don't scrub it. Avoid swimming for two weeks or until the catheter is removed.