One Stage Urethraplasty

Why is it done?

• To treat urethral strictures (narrowing) caused by trauma, infection, malignancy, etc. Shorter strictures less than 2 cm in length.

How is it done?

• This procedure is done under general anesthetic.
• Legs are placed in a lithotomy position.
• A single incision is made on the midline raphe on the perineum (area between scrotum and anus).
• The corpus spongiosum identified and exposed
• Stricture located using urethral sounds
• The stricture is excised with a spatulated anastomosis over an indwelling catheter
• A long-term catheter will be inserted for 10 days.
• A dressing is then applied, which should be removed after 72 hours.
• A local anaesthetic is injected into the wound, thus giving post-operative pain relief for the next 4-6 hours.
• A drain may also be left for 24-48 hours to prevent the collection of serous fluids.

What to expect after the procedure?

• Any anaesthetic has its risks and the anaesthetist will explain all such risks.
• You will be sent home with an Indwelling catheter for 7-10 days
• Bleeding is a common complication.
• A haematoma (blood collection under the skin) may form and needs to be reviewed by Dr Schoeman as soon as possible. Bruising is normal.
• An infection of the wound may occur and requires immediate attention.
• Erectile dysfunction (15%) may occur.
• Re-stricturing (20-30%) may occur.
• Owing to the area of the surgery the wound should be kept clean and dry.
• DANGER SIGNS: A scrotum that swells immediately to the size of a football, fever, or puss. Please contact Dr Schoeman or the hospital immediately as this may occur in up to 15 % of all cases.

What next?

• The dressing should be kept dry for the initial 72 hours after surgery and then soaked in a bath until it comes off easily.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
• Arrangements will be made for the removal of the catheter after 7-10 days.
• A urinating Urethragram will be arranged with radiology within 6 weeks to determine the final result of the surgery.
• There will be signs of bruising for at least 10 days.
• The suture-line will be hard and indurated for at least 8-10 weeks.
• PLEASE CONTACT THE HOSPITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

Download Information Sheet

Wes Urethraplasty One-Stage