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Ureteral Reconstruction

What is Ureteral Reconstruction?

Urethral reconstruction is a surgical procedure to repair or rebuild the urethra, typically performed to correct severe urethral strictures or damage caused by trauma, infection, or prior medical procedures. When the urethra becomes narrowed or blocked, it can lead to difficulty urinating, recurrent infections, and kidney complications. Reconstruction provides a long-term solution for restoring normal urine flow and improving quality of life.

Risk Factors

Several conditions can lead to urethral damage requiring reconstruction, including:

  • Severe or recurrent urethral strictures – Caused by scar tissue from infection, inflammation, or previous treatments.
  • Pelvic trauma or injury – Fractures or blunt-force injuries to the pelvis may damage the urethra.
  • Complications from previous urethral surgeries or catheterization – Prolonged catheter use or failed urethrotomy procedures can cause further scarring.
  • Radiation therapy – Treatment for pelvic cancers may lead to urethral narrowing.
  • Congenital abnormalities – Some men are born with urethral defects requiring reconstruction.

Symptoms

Urethral damage or strictures can cause progressive urinary symptoms, including:

  • Weak or slow urine stream
  • Straining to urinate
  • Incomplete bladder emptying
  • Urinary tract infections (UTIs)
  • Pain or discomfort during urination

Treatment

Urethral reconstruction is a highly specialized procedure, with the approach depending on the severity and location of the stricture.

Urethroplasty (Open Surgical Reconstruction)

  • The gold standard for complex or recurrent urethral strictures.
  • Involves removing the scarred section and either reconnecting healthy tissue (end-to-end anastomosis) or using tissue grafts for reconstruction.
  • Graft materials may include buccal mucosa (from the inner cheek), skin, or other tissues.
  • Provides long-lasting results with a lower recurrence rate than endoscopic treatments.

Endoscopic Surgery (Minimally Invasive Option for Short Strictures)

  • Direct Vision Internal Urethrotomy (DVIU) – A laser or scalpel is used to make a small incision in the scar tissue.
  • Best for short strictures, though recurrence rates are higher than with urethroplasty.

Prevention

While not all cases requiring urethral reconstruction can be prevented, certain steps can reduce the risk of severe strictures or damage:

  • Minimize catheter use – Avoid unnecessary catheterization or ensure proper technique.
  • Seek early treatment for urinary infections & trauma – Prompt care can prevent long-term scarring.
  • Practice safe sex – Prevent sexually transmitted infections (STIs) that may lead to urethral inflammation.
  • Avoid injury to the pelvic area – Use protective gear during contact sports or high-impact activities.

Urethral reconstruction offers effective, long-term relief for men with significant urethral damage or strictures. If you're experiencing urinary difficulties, a urology specialist can determine the best treatment.