Urethroplasty in India

Urethral stricture is a narrowing of the urethra, the tube that carries urine out of the body, caused by scar tissue from injury, infection, prior catheterisation, certain medical procedures, or in some cases an unknown cause. As the passage narrows, it restricts urine flow, causing symptoms like a weak stream, straining, incomplete emptying, or recurrent urinary infections. Urethroplasty, the surgical reconstruction of the narrowed segment, is considered the gold-standard, most durable treatment, unlike temporary measures such as dilation or internal urethrotomy, which often need to be repeated as the stricture tends to recur.

Excision and primary anastomosis

For shorter strictures, generally in the bulbar (mid) urethra, the narrowed segment can often be surgically removed entirely, with the two healthy ends of the urethra then rejoined directly. This technique, called excision and primary anastomosis, has excellent long-term success rates and is considered when the stricture length and location make it feasible.

Graft urethroplasty

For longer strictures, or those not suited to direct rejoining, the narrowed segment is instead widened using a tissue graft, most commonly taken from the inside of the cheek (buccal mucosa), which is well suited to this purpose due to its durability and how it heals inside the body. This graft is used to patch and widen the narrowed urethral segment, restoring an adequate channel for urine flow.

Diagnostic imaging before surgery

Before surgery, imaging such as a retrograde urethrogram (RUG) and voiding cystourethrogram (VCUG), specialised X-rays that map the exact location and length of the stricture, are used to plan the surgical approach. Getting this imaging right is central to choosing the correct technique and predicting how the surgery is likely to go.

Why the catheter period affects your travel plan

After urethroplasty, a catheter typically remains in place for around 2 to 3 weeks while the reconstructed urethra heals, considerably longer than after most other urology procedures. Before the catheter is removed, a follow-up voiding cystourethrogram is generally done to confirm the reconstruction has healed properly and there's no leakage, which is why the recommended stay in India is longer than many other urological surgeries. Removing the catheter too early, based on convenience rather than confirmed healing, isn't advised.