Urethroplasty is surgery to repair a urethral stricture. Unlike dilation or cutting the scar from the inside, it removes or bypasses the scar, which is why it's the long-term option for strictures that keep coming back.

Who it's for

Men whose stricture has returned after dilation or urethrotomy, men with longer strictures, and men who would otherwise rely on repeated procedures or self-catheterization.

The two main approaches

• Excision and primary anastomosis: for short strictures, usually in the bulbar urethra. The scarred segment is removed and the healthy ends are rejoined.

• Graft urethroplasty: for longer strictures. The narrowed area is opened and widened with a graft of tissue from inside the cheek (buccal mucosa).

Some complex strictures, especially after hypospadias repair or with lichen sclerosus, are repaired in two stages.

Recovery

Most men go home the same day or the next morning with a catheter, usually for two to three weeks. An X-ray dye study confirms healing before the catheter comes out. If a cheek graft was used, the inside of the mouth is sore for about a week. Desk work usually resumes in one to two weeks, and sex after about four to six weeks.

Risks

Swelling and bruising, infection, temporary numbness of the perineum, changes in erections or ejaculation in some men, and the stricture coming back. I review your specific risks based on the location and length of your stricture.

Related

Before urethroplasty · Recovery and catheter care · Cheek graft mouth care · Urethral strictures