Urethroplasty
What is Urethroplasty ?
Urethroplasty is a surgical procedure to repair or reconstruct the urethra, typically to treat urethral strictures (narrowing due to scarring) or other defects like hypospadias. Unlike temporary measures like dilation or stents, urethroplasty offers a long-term solution by removing or bypassing the scarred tissue. In India, urethroplasties are performed in urology departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Urethroplasty ?
Urethroplasty is indicated for:
- Urethral strictures:
- Narrowing due to trauma (e.g., pelvic fracture), infection, prior surgery (e.g., TURP, 1–2% risk as in your query), or catheterization.
- Symptoms: Weak stream, urinary retention, recurrent UTIs; 0.6–1% of men affected in India.
- Recurrence after urethrotomy (endoscopic incision; 30–50% recur within 1–2 years).
- Other indications:
- Hypospadias repair (congenital defect; urethra opens on underside of penis; often corrected in childhood).
- Urethral fistula or trauma (e.g., post-accident).
- Associated treatments:
- Pre-op: Urethrotomy or dilation often tried first; stent removal if previously placed.
- Post-op: Catheter (urethral or suprapubic) for 2–4 weeks to allow healing.
- Timing:
- Performed in adults (average age 30–50 years for strictures) or children (for hypospadias); elective unless urgent (e.g., complete obstruction).
The procedure aims to restore normal urethral function, improve urine flow, and reduce complications like infections or retention, with a high success rate for long-term patency.
Why Do Urethroplasty Costs Vary in India?
Costs range from ₹80,000 to ₹3 lakh:
- Procedure Type: Anastomotic (₹80,000–₹1.5 lakh); substitution with graft (₹1.5–3 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹1.5–3 lakh); lower in government hospitals (AIIMS: ₹30,000–₹80,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced urologists charge more.
- Additional Costs: Anesthesia (₹10,000–₹20,000), hospital stay (₹5,000–₹15,000/day), imaging (₹5,000–₹10,000), medications/catheter (₹5,000–₹15,000).
- Insurance: Often covered (medical necessity); confirm with your provider.
Urethroplasty Procedure
- Before Surgery Evaluation:
- Assessment:
- Retrograde urethrogram (RUG) or voiding cystourethrogram (VCUG): Maps stricture length, location, and severity.
- Urethroscopy: Visualizes stricture (complements your ureteroscopy query).
- Blood tests: Blood sugar (infection risk in diabetics), clotting profile.
- Urine test: Ensures no active UTI (treated pre-op).
- Preparation: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotics pre-op.
- Consent: Risks, including recurrence, are explained.
- Assessment:
- Surgical Technique:
- Urethroplasty:
- Performed under general or spinal anesthesia, lasting 2–4 hours (depends on complexity).
- Types:
- Anastomotic urethroplasty: For short strictures (<2 cm, 40–50% of cases); scarred segment excised, healthy ends reconnected.
- Substitution urethroplasty: For longer strictures (>2 cm); uses graft (e.g., buccal mucosa from cheek) or flap to reconstruct urethra.
- Staged urethroplasty: For complex cases (e.g., long strictures, prior failures); urethra rebuilt in two surgeries 3–6 months apart.
- Process:
- Incision: Perineal (between scrotum and anus) or penile, depending on stricture location.
- Stricture excised (anastomotic) or opened and replaced with graft/flap (substitution).
- Urethra reconstructed with fine sutures; catheter placed to stent repair (urethral or suprapubic).
- Closure: Sutures in layers; drain (if needed) for 1–2 days.
- Intraoperative Tools:
- Urethroscope: Confirms stricture location.
- Buccal mucosa graft: Harvested from cheek (common, 80% success for substitution).
- Doppler: Ensures blood supply to flap (if used).
- Urethroplasty:
- After Surgery:
- Hospital stay: 2–4 days.
- Care: Catheter remains for 2–4 weeks; antibiotics for 7–10 days; avoid straining.
- Pain management: Moderate pain for 3–5 days (perineal or penile); managed with painkillers (e.g., paracetamol).
- Instructions: Avoid sexual activity or heavy lifting for 6–8 weeks; monitor urine output.
Recovery After Urethroplasty
- Hospital Stay: 2–4 days.
- Post-Surgery Care:
- Pain: Moderate pain for 3–5 days (incision site); resolves in 1–2 weeks.
- Urine: Catheter (urethral or suprapubic) for 2–4 weeks; mild hematuria initially; clears in 3–5 days.
- Activity: Avoid strenuous activity for 6–8 weeks; light activities in 1–2 weeks.
- Catheter removal: At 2–4 weeks; urethrogram confirms no leak before removal; temporary leakage or urgency may follow.
- Incision: Perineal or penile scar fades in 3–6 months.
- Follow-Up:
- Visits at 1 week (check healing), 2–4 weeks (catheter removal), and 3–6 months (assess outcome).
- Uroflowmetry: At 3 months to confirm improved flow (typically >15 mL/s); success rate 85–90%.
Most resume normal activities in 2–3 weeks; full recovery takes 6–8 weeks. Success rate: 85–90% long-term patency for anastomotic; 75–80% for substitution; staged procedures may reach 90% with time.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Hematoma at incision site; may resolve or need drainage.
- Infection (3–5%): Wound or UTI; treated with antibiotics; higher risk in diabetics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Urine leak (2–5%): From suture line; may need prolonged catheterization.
- Recurrence (10–20%): Stricture returns (higher with substitution); may need repeat surgery.
- Erectile dysfunction (5–10%): Temporary (resolves in 3–6 months); permanent in <1% (perineal approach).
- Fistula (1–2%): Abnormal connection to skin; may need repair.
- Long-Term:
- Urethral narrowing (5–10%): Scar tissue; may need dilation or redo urethroplasty.
- Incontinence (1–2%): Rare; usually temporary if sphincter unaffected.
Report fever, severe pain, heavy bleeding, or inability to urinate post-catheter removal promptly.
Frequently Asked Questions (FAQs)
What causes the need for urethroplasty?
Urethral strictures (trauma, infection, prior surgery), hypospadias, or trauma-related defects.
Can I avoid urethroplasty?
Yes, if mild: Urethrotomy, dilation, or stents (as in your prior query); urethroplasty needed for recurrent or severe strictures.
Is urethroplasty painful?
Moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 1–2 weeks; full recovery: 6–8 weeks; avoid strenuous activity for 6–8 weeks.
Is urethroplasty covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, heavy bleeding, or inability to urinate post-catheter removal.
Will urethroplasty affect urination or sexual function?
Urination improves (85–90% success); erectile function usually preserved (5–10% temporary issues).
Lifestyle changes post-surgery?
Avoid trauma to urethra, hydrate well, monitor for recurrence, and attend follow-ups.
Conclusion
Urethroplasty is a highly effective procedure for treating urethral strictures, offering a long-term solution with a high success rate and manageable recovery. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a urologist for personalized guidance.
Looking for Best Hospitals for Urethroplasty
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
80,000 |
2,00,000 |
Ahmedabad |
1,00,000 |
2,50,000 |
Ajmer |
80,000 |
2,00,000 |
Aligarh |
80,000 |
2,00,000 |
Allahabad |
80,000 |
2,00,000 |
Amritsar |
90,000 |
2,25,000 |
Aurangabad |
90,000 |
2,25,000 |
Bangalore |
1,00,000 |
2,50,000 |
Bareilly |
80,000 |
2,00,000 |
Belgaum |
90,000 |
2,25,000 |
Bhopal |
90,000 |
2,25,000 |
Bhubaneswar |
90,000 |
2,25,000 |
Bikaner |
80,000 |
2,00,000 |
Chandigarh |
1,00,000 |
2,50,000 |
Chennai |
1,00,000 |
2,50,000 |
Coimbatore |
1,00,000 |
2,50,000 |
Dehradun |
90,000 |
2,25,000 |
Delhi |
1,00,000 |
2,50,000 |
Dhanbad |
80,000 |
2,00,000 |
Durgapur |
80,000 |
2,00,000 |
Faridabad |
1,00,000 |
2,50,000 |
Ghaziabad |
1,00,000 |
2,50,000 |
Gorakhpur |
80,000 |
2,00,000 |
Guntur |
90,000 |
2,25,000 |
Gurgaon |
1,00,000 |
2,50,000 |
Guwahati |
90,000 |
2,25,000 |
Gwalior |
80,000 |
2,00,000 |
Hyderabad |
1,00,000 |
2,50,000 |
Indore |
90,000 |
2,25,000 |
Jabalpur |
80,000 |
2,00,000 |
Jaipur |
1,00,000 |
2,50,000 |
Jalandhar |
90,000 |
2,25,000 |
Jamshedpur |
90,000 |
2,25,000 |
Jodhpur |
80,000 |
2,00,000 |
Kanpur |
80,000 |
2,00,000 |
Kochi |
1,00,000 |
2,50,000 |
Kolkata |
1,00,000 |
2,50,000 |
Kollam |
90,000 |
2,25,000 |
Lucknow |
90,000 |
2,25,000 |
Ludhiana |
1,00,000 |
2,50,000 |
Madurai |
90,000 |
2,25,000 |
Mangalore |
90,000 |
2,25,000 |
Meerut |
80,000 |
2,00,000 |
Moradabad |
80,000 |
2,00,000 |
Mumbai |
1,00,000 |
2,50,000 |
Mysore |
1,00,000 |
2,50,000 |
Nagpur |
90,000 |
2,25,000 |
Nashik |
90,000 |
2,25,000 |
Navi Mumbai |
1,00,000 |
2,50,000 |
Noida |
1,00,000 |
2,50,000 |
Patna |
80,000 |
2,00,000 |
Pune |
1,00,000 |
2,50,000 |
Raipur |
90,000 |
2,25,000 |
Rajkot |
90,000 |
2,25,000 |
Ranchi |
80,000 |
2,00,000 |
Surat |
1,00,000 |
2,50,000 |
Thane |
1,00,000 |
2,50,000 |
Vadodara |
90,000 |
2,25,000 |
Varanasi |
80,000 |
2,00,000 |
Visakhapatnam |
90,000 |
2,25,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.