Urethral Reconstruction Surgery: Risks and Concerns

Q: Urethral Reconstruction Surgery: Risks and Concerns

Hello, sir： Thank you for your inquiry. <br>I would like to respond to your question and provide the following advice： Regarding urethral reconstruction surgery, it is not as straightforward as you might think. <br>If the segment of the urethra that is narrowed is too long to sta

Urethral reconstruction surgery?

Hello, Doctor.
I would like to ask about urethral reconstruction surgery.
After excising the narrowed portion, the proximal and distal ends are joined together.
What potential complications might arise from this surgery? Is there a possibility of recurrence of the stricture? Will it affect sexual function? I am very concerned about the impact on erectile function.

zero point zero, 20~29 year old female. Ask Date: 2010/08/19

Dr. Lin Hexing reply Urology

Hello, sir: Thank you for your inquiry.
I would like to respond to your question and provide the following advice: Regarding urethral reconstruction surgery, it is not as straightforward as you might think.
If the segment of the urethra that is narrowed is too long to stabilize directly, it may be necessary to use other tissue to create a segment of the urethra that can be anastomosed without tension.
Potential postoperative complications include recurrence of stricture, and erectile dysfunction is rarely a concern.
These issues are best discussed with the physician who is treating you.
Finally, I wish you peace and happiness!

Reply Date: 2010/08/19

More Info

Urethral reconstruction surgery is a procedure aimed at addressing urethral strictures, which are narrowings of the urethra that can lead to urinary difficulties. This surgery typically involves excising the narrowed segment of the urethra and reconnecting the proximal and distal ends. While this procedure can significantly improve urinary function, it is essential to understand the potential risks and complications associated with it.

One of the primary concerns following urethral reconstruction is the possibility of recurrence of the stricture. Studies indicate that the recurrence rate can vary depending on several factors, including the length and location of the stricture, the surgical technique employed, and the underlying cause of the stricture. In some cases, strictures can recur, necessitating further interventions. It is crucial to have regular follow-up appointments with your urologist to monitor for any signs of recurrence.

Another significant concern is the potential impact on sexual function, particularly erectile function. While urethral reconstruction primarily focuses on restoring urinary flow, the surgical procedure can inadvertently affect surrounding structures, including nerves and blood vessels that are crucial for erectile function. However, many patients do not experience significant changes in sexual function post-surgery. It is essential to discuss any concerns about erectile function with your surgeon before the procedure, as they can provide insights based on your specific situation and the surgical approach planned.

Other potential complications of urethral reconstruction surgery include:
1. Infection: As with any surgical procedure, there is a risk of infection at the surgical site. Proper postoperative care and hygiene can help mitigate this risk.

2. Urinary Incontinence: Some patients may experience temporary or, in rare cases, permanent urinary incontinence following the surgery. This can be due to changes in the urethra or surrounding structures.

3. Fistula Formation: A fistula is an abnormal connection between the urethra and another structure, such as the skin or vagina. This can occur as a complication of the surgery and may require additional surgical intervention.

4. Scarring: Scarring at the surgical site can lead to further narrowing of the urethra, which may necessitate additional treatments.

5. Pain or Discomfort: Postoperative pain is common, but it should gradually improve. Persistent pain may indicate complications that need to be addressed.

To minimize risks and enhance recovery, it is vital to follow your surgeon's postoperative care instructions closely. This may include avoiding strenuous activities, maintaining proper hydration, and attending all scheduled follow-up appointments.

In conclusion, while urethral reconstruction surgery can effectively treat strictures and improve urinary function, it is essential to be aware of the potential risks and complications. Open communication with your healthcare provider about your concerns, including the impact on sexual function and the risk of recurrence, will help you make informed decisions and prepare for the recovery process. Always remember that individual outcomes can vary, and your surgeon can provide personalized information based on your specific case.

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