Reconstructive Surgery for Urethral Strictures

A urethral stricture is scar tissue in the urethra that can block the flow of urine.  Urethral strictures are more common in men because their urethras are longer than in women and are more susceptible to disease or injury.  Urethral stricture is usually not a congenital (born with) problem and women rarely develop urethral strictures.

For patients with urethral stricture disease, urethroplasty is often the treatment of choice. Urethroplasty is a surgical procedure most often performed by a reconstructive urologist that repairs the scarred urethra to restore normal urine flow. The type of urethroplasty recommended for your condition will depend on the size and location of the stricture.

Several types of urethroplasty procedures exist. Two examples include:

  • Buccal graft urethroplasty is a procedure where the reconstructive urologist will take tissue from the skin lining inside of the mouth and transfer or graft the tissue to the urethra to create an open pathway for urine.

  • EPA- excison and primary anastomosis - Cut the bad segment of urethra out and put back together without any additional grafts or flaps. 

 

SURGICAL PROCEDURES FOR URETERAL INJURY AND CONGENITAL CONDITIONS

Andrew ChangIn addition to urethroplasty for stricture disease, Dr. Andrew Chang (pictured right), Chesapeake Urology's reconstructive urologist, performs reconstructive surgery for patients who experience ureteral injuries as well as congenital conditions including:

  • Boari flap and Psoas hitch - For ureteral injuries that are close to the bladder, the reconstructive urologist creates a flap out of the bladder (boari flap) to substitute the segment missing in the ureter, or can perform a psoas hitch, which attaches a portion of the bladder wall to the psoas muscle.

  • Ileal ureteral substitution and transureteroureterostomy (TUU) are urinary diversion techniques that take a segment of the small bowel to replace portions of the ureter damaged by injury. These procedures are typically performed on large defects of the ureter.

  • Laparoscopic pyeloplasty is a surgical procedure performed to correct an obstruction between the kidney and the ureter (the tube that carries urine to the bladder).