David Dickerson and his team in Bristol offer consultation and surgical treatment for conditions affecting the urethra. Urethral surgeries include urethra reconstruction and urethroplasty.
The urethra is the tube through which urine passes from the bladder out of the body. The urethra and penile areas can sometimes need surgical treatment:
Abnormalities can occur in the development of the penis and urethra. A common example of this is hypospadias which is present from birth. This condition is when the urethra opens on the underside of the penis instead of the end of the penis. It can open anywhere from just below the normal position to as far back as the scrotum.
The urethra can become constricted, this is known as urethral stricture and mainly affects men. Urethral stricture will slightly or highly restrict urinary flow.
Urethral stricture is a condition that mainly affects men. It involves the constriction of the urethra. The stricture will slightly or highly restrict urinary flow. Strictures are usually caused by inflammation or scar tissue. The following can put you at higher risk of experiencing urethral stricture:
- Having an sexually transmitted infection (STI)
- Use of a catheter (a thin tube inserted into the body to drain the bladder)
- Having urethritis (irritation and swelling in the urethra)
- Having an enlarged prostate
- Injury or trauma to the area
- Penile implants
A bulbar stricture is the most common stricture and affects the bulbar urethra, which is located under the scrotum in an area called the perineum. This is the most vulnerable area to trauma such as straddle injuries or being hit or kicked.
Lichen Sclerosis is a condition of the penis and urethra. Symptoms include a discolouration of the skin of the penis, a smoothing of the indentation between the head of the penis and the shaft of the penis and the urethra opening on the underside of the penis. Lichen Sclerosis can also come with associated urethral strictures.
Surgical Treatments
Urethral dilation is a common treatment for urethral stricture. In this procedure a thin tube-like instrument called a dilator is inserted into the urethra which then expands to stretch the urethra. Depending on the amount of stretching required this may have to be done several times with larger dilators. In some cases you may be able to dilate your stricture yourself at home.
Urethroplasty is an open surgical repair where an incision is made in the penis while treating strictures or abnormalities. There are different types of urethroplasty surgery recommended depending on the size, location and cause of the stricture or abnormality. When visiting one of our clinics in Bristol, your specialist will be able to recommend the most appropriate surgery for you.
In some situations the urethra can be repaired with a single-stage surgery. The length of the urethra affected is removed and the two healthy ends are reconnected. The elasticity of the urethra usually allows successful reconnection.
If two stages of surgery are required an incision is made in the urethra and a graft (a transplant of tissue, often taken from the cheek) is inserted into the gap where the stricture was to reconnect the two healthy ends of the urethra. This is known as a buccal mucosal graft. There is a period of several months between the graft being inserted and the urethra being fully repaired. This allows the graft to become suppler, so it can be reconstructed easily in the second stage of the surgery.
