What is "urethroplasty"

Urethroplasty \U*re"thro*plas`ty\, n. [Urethra + -plasty.] (Surg.) An operation for the repair of an injury or a defect in the walls of the urethra. -- U*re`thro*plas"tic, a.

n. (context surgery English) Surgery involving the repair of the urethra.

In surgery, urethroplasty is the repair of an injury or defect within the walls of the urethra. There are four commonly used types of urethroplasty performed; anastomotic, buccal mucosal onlay graft, scrotal or penile island flap (graft), and Johansen's urethroplasty. The choice of procedure is dependent on factors including:

• physical condition of the patient
• overall condition of the remainder of the urethra (not affected by the stricture)
• the length of the defect (best determined by urethrography)
• multiple or misaligned strictures
• anatomical positioning of the defect with regard to the prostate gland, urinary sphincter, and ejaculatory duct
• position of the most patent area of the urethral wall (necessary for determination of the location of the onlay/graft site, most often dorsal or ventral)
• complications and scarring from previous surgery(ies), stent explantation (if applicable), and the condition of the urethral wall
• availability of autograft tissue from the buccal cavity (buccal mucosa) (primary selection)
• availability of autograft tissue from the penis and scrotum (secondary selection)
• skill level and training of the surgeon performing the procedure

Note: in more complex cases, more than one type of procedure may be performed, especially where longer strictures exist.

With an average operating room time of between three and eight hours, urethroplasty is not considered a minor operation. Patients who undergo a shorter duration procedure may have the convenience of returning home that same day (between 20% and 30% en total of urethroplasty patients). Hospital stays of two or three days duration are the average. More complex procedures may require a hospitalization of seven to ten days. The length-of-stay is usually determined by the:

• status/condition of the patient, post recovery
• after-effects of the anesthesia/sedation/spinal anesthesia utilized during the procedure
• anticipated post-surgical care, per care plan (dressing changes, packing changes, and monitoring of (any) surgical drains - if used)
• monitoring of the newly established urethral cysostomy (Johansen's urethroplasty) if applicable
• monitoring of the suprapubic catheter or Foley catheter for signs of infection and proper urine output if applicable
• titration of palliative and anti-spasmodic medication(s) if applicable
• post surgical complications if any