The urethroplasty in Noida is frequent processes developed as a result of trauma (introduction of instruments or foreign bodies in the urethra, external forces, “piercing” urethral, etc.) or infections (urethritis), primarily affecting males given its urethral length and present with narrowing of the urethral lumen, secondary to a scarring process of the spongy body (spongiofibrosis), of variable length and depth; They can be single or multiple and affect any urethral segment.
The logical consequence of urethral strictures is the obstruction of urination, so they usually present with the following symptoms:
- decreased urinary jet strength or inability to urinate
- need to urinate frequently
- Urinary infections
- inflammations and infections of the prostate (prostatitis)
- drooling ejaculation
The choice of initial treatment is crucial since the first opportunity is the best of all. It is necessary to base the decision on the treatment to be performed on an adequate diagnostic evaluation.
Many years ago, the treatment of urethral strictures was performed according to a “treatment ladder” in which all strictures were treated in the same way, regardless of their location or length.
First, a dilation was carried out. When the stenosis recurred, it was dilated again or treated with one or more internal urethrotomy. These two procedures were often performed associated with intermittent catheterization to try to “stabilize” the urethra. Frequently, these treatments were carried out without an adequate prior diagnostic study. Only when after multiple dilations and urethrotomy did the stenosis not respond (a very frequent evolution with this treatment) was open reconstruction recommended as an option. This progression, from dilatation to urethrotomy and from urethrotomy to open surgery, was what was known as the “treatment ladder,” which today is completely ruled out.
We have observed that many of our patients have undergone dilations and urethrotomy without previous diagnostic imaging studies. In addition, many have suffered a series of up to 30 dilations and / or multiple urethrotomy without being offered open reconstruction. This cannot be considered adequate today.
The modern approach to urethral stenosis requires a previous full evaluation and a decision on the treatment based on the location and length of the stenosis.
The dilation or urethrotomy may be a valid treatment option in individual cases or to obtain a temporary improvement with the less invasive approach. In many other cases, these procedures are not suitable options. This is especially true when the strictures are not short since in them the failure rates of dilation or urethrotomy are close to 100%. In addition, a trauma that involves dilation or urethrotomy can aggravate the disease.
The open reconstructive surgery of the urethra, performed by a urologist in Ghaziabad with sufficient experience may be the best option for initial treatment in most cases. Excision and anastomosis definitely cure 98% of cases, this means that it is not necessary to perform probes or dilations to maintain the caliber of the urethra. When it is necessary to use pedicle or free grafts, the success rate is a little lower, but usually heals 80% – 90% of patients.
Modern surgical techniques performed by a urethral reconstruction specialist or plastic surgeon in Delhi using the appropriate instruments and equipment are associated with high cure rates and with few complications. However, treatment should be chosen in view of a thorough diagnostic study and adapted to each individual patient.