Urethrotomy vs urethroplasty (graft )...

Urethrotomy vs urethroplasty (graft ) vs excision

Posted in the Urology Forum


Bangalore, India

#1 Feb 4, 2009
I have been diagnosed with urethral stricture of about 1 cm in length. When doctor tried RGU(retrograde urethrogram), he had trouble inserting the smallest size catheter(5mm)(across stricture).
RGU report says:
a) penile urethra is normal
b) circumferential narrowing is seen at the level of bulbar urethra
c)visualization of membranous urethra proximal to the narrowing
d) membranous urethra shows good distension
e) retro grade catheterization across the narrowing for MCU could not be done due to form obstruction

Also, I did a self analysis of urine flow (passed about 295ml in 1 minute)=~5ml /sec.

I dont seem to recall any symptoms of any STD / UTI, except that I notice few years back that I used to have burning sensation after urinating after sexual activity, esp when i would take carbonated drinks.

Anyway, my objective here is to understand which corrective surgery I should be going for. I talked to two doctors, both suggesting differently.

a) Urethrotomy ( internal ). I have been told that, post this approach I will have to do CISC for about 6 months.
From whatever I have read so far, it is highly likely (60-70%) that stricture would come back. Now, I dont want end up doing CISC, if it is 'bound' to come back.

one doctor suggests that since this is my first surgery and stricture is small (1cm), i should go for endoscopic procedure.

b) urethroplasty (graft)
Since, i showed discomfort towards CISC, other doctor suggests that for permanent solution, i should rather go for Buccal Mucosa Urethroplasty.
( first doctor says it might be overkill for short stricture, that too when its first surgery).

c) Urethroplasty (Excision)
one more option is to go for the excision. Now, if I choose this, what are the chances of recurrence, and the side effects of shortening the urethra (stricture length = 1 cm)

Apart from this I have query about risks of acquiring impotency, in case i choose to go for open surgery ( excision, or urethroplasty).

Chennai, India

#3 Nov 19, 2013
what u have done i want your response as i am also suffering from same problem

Boston, MA

#4 Apr 8, 2015
I had the Urethroplasty done when I was 62 years old, and when I woke up the doctor was pleased he did not have to do the graft, he was able to do an excision when he really saw what was going on..... Look -- the surgery and recovery is not fun, chances are you will be pretty numb in the genitals for quite some time. However, I PISS like a RACEHORSE, FIREHOSE! IT WORKS!!

Canberra, Australia

#5 Jul 12, 2016
I have had 3 urethetomy and multiple dilations over a 30 year a period that so much scar tissue has been generated and closed right down over a lofetime that the only option was urethroplasty.

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