For longer and recurring urethral strictures that may not respond to treatment by dilation, surgery is usually required to widen or remove the narrowed section of the urethra. At NYU Langone, our doctors perform two types of surgery for urethral strictures: urethrotomy and urethroplasty.
In a urethrotomy, a surgeon uses a special endoscope, which is a thin instrument with a light embedded in the tip, to make an incision in the part of the urethra that is blocking the flow of urine. The incision helps widen the stricture. After this procedure, a catheter is left in place for a few days to divert urine away from the urethra during the healing process.
This procedure takes place in the hospital but does not require an overnight hospital stay. Because you may have pain and discomfort after the procedure for up to two weeks, your doctor may prescribe pain relief medication, as necessary. You should avoid sexual intercourse for one week after urethrotomy.
NYU Langone surgeons are among a handful in New York City who perform urethroplasty, a surgery to remove scar tissue and widen the urethra. Our surgeons specialize in performing urethroplasty for strictures caused by prostate cancer radiation therapy. This surgery is often performed after urethral dilation fails to fix the stricture, or when the stricture is too long for dilation.
In urethroplasty, a surgeon locates and removes the narrowed section of the urethra and joins together the two healthy pieces. If the scarred segment of the urethra is too long to be removed, doctors may use tissue from other parts of the body to recreate the normal size of the urethra. This increases the size of the urethra, allowing urine to flow without difficulty.
Urethroplasty is performed in the hospital but typically as an outpatient procedure, allowing you to go home the same day. Some people may be discharged the following day, if they need more time for recuperation. A catheter remains in the urethra for two to three weeks after surgery to help with urination while the urethra heals.
The long-term success rate of urethroplasty is high. About 80 percent to 90 percent of people who have had urethroplasty can expect permanent relief from urethral stricture.