Do you find it hard to urinate? Does your urine stream feel thin, weak, or blocked? Sometimes, even after you finish, you might still feel like your bladder is not completely empty. This can happen when your urinary tube gets narrowed or blocked.
This problem often happens if you recently suffered an injury, especially to your pelvic area, or if you received treatment for prostate cancer. If you are dealing with this frustrating issue, there is a very good surgical solution available. It is called posterior urethral reconstruction.
Key Takeaways
- Posterior urethral reconstruction is a highly successful surgery that fixes narrow or blocked sections in the back part of your urinary tube.
- This condition most commonly occurs after severe pelvic injuries or prostate cancer treatments.
- Following your doctor's instructions during the recovery period is essential for healing safely.
- The main goal of this surgery is to restore normal, pain-free urination and improve your overall quality of life.
BMI Calculator
Know your body mass index (BMI) and weight classification
What Is Posterior Urethral Reconstruction?
To understand this procedure, let us first look at how your body works. The urethra is the tube that carries urine and semen from your bladder out of your body. This tube has a few different parts.
The posterior urethra is the back part of this tube, located deep inside your body. To be exact, it is the short one-to-two-inch section that starts at the base of your bladder, passes through your prostate gland, and runs through the muscles of your pelvic floor.
Therefore, posterior urethral reconstruction is a surgery that repairs, opens up, and rebuilds this back part of the urinary tube when it becomes damaged, narrowed, or scarred.
Why Is This Surgery Needed?
The main reason doctors perform this surgery is to treat a condition called a urethral stricture. Just like a water pipe that gets clogged and slows down water flow, scar tissue can form inside your urinary tube and narrow the passage. This makes passing urine very difficult. Your urine stream may become very thin or stop completely.
There are two main causes of urethral strictures:
| Cause | Description and Examples |
|---|---|
| Severe Pelvic Fractures and Trauma |
Severe injuries to your pelvic or hip area can damage your urinary tube. Examples include:
|
| Prostate Cancer Treatments |
Certain treatments for prostate cancer can also cause scarring and narrowing over time. These include:
|
Clinical vitamins and nutritional supplements
Clinically proven high quality vitamins, minerals and immune nutritional supplements.
Check Availability →What Tests Are Done Before Surgery?
Before your doctor decides to perform this surgery, they need to know how narrow your urinary tube is and where the damage is located. They will order several diagnostic tests:
- Retrograde Urethrogram: A special dye is gently put into your urinary opening, and X-ray pictures are taken.
- Voiding Cystourethrogram: A small tube is placed in your bladder to fill it with fluid, and X-rays are taken while you urinate.
- Cystoscopy: A very thin tube with a tiny camera is guided into your urinary tube to inspect the inside directly.
- MRI Scan: Sometimes, an MRI is used to get a clearer, more detailed picture of your pelvic area.
Important Note: If your stricture is the result of a recent accident, doctors will wait until your body and injuries are stable. During this healing period, a small tube is often placed through your lower belly directly into your bladder to drain urine. This tube is called a suprapubic catheter.
How to Prepare for Surgery
Following your doctor's instructions before your surgery is essential for your safety and a smooth recovery.
| What You Should Do | Why It Matters |
|---|---|
| Tell your doctor about all your allergies. | This helps prevent dangerous allergic reactions to medicines given during surgery. |
| Share a list of all medicines, vitamins, and herbal supplements you take. | Some products can interfere with surgery or anesthesia. |
| Stop blood-thinning medicines as instructed by your doctor. | This prevents excessive or dangerous bleeding during the operation. |
| Do not eat or drink anything for 8 to 12 hours before surgery. | Having an empty stomach keeps you safe from vomiting while under general anesthesia. |
Your doctor may also prescribe antibiotics starting a day before your surgery to prevent any potential infections.
How the Surgery Is Performed
First, an anesthesiologist will give you general anesthesia. This means you will fall into a deep, comfortable sleep. You will feel no pain and be entirely unaware during the procedure.
Once you are asleep, your urologist will begin the operation. For strictures caused by pelvic injuries, the most common and effective technique used is called an anastomotic urethroplasty.
Here is how the procedure works step by step:
- The surgeon makes a small incision in the perineum, which is the area between your scrotum and your anus.
- The scarred, narrowed section of your urinary tube is carefully located and removed.
- The healthy ends of your urinary tube are brought back together and stitched carefully with very fine sutures.
Sometimes, removing the scarred section leaves a gap that is too wide to close directly. When this happens, surgeons perform a wonderful technique. They take a tiny patch of tissue "on loan" from the inside of your cheek or lip (buccal mucosa) and use it to bridge the gap and rebuild your urinary tube.
This surgery typically takes between three to six hours to complete.
What Happens After Surgery?
After your surgery is finished, the incision is carefully closed and covered with a clean bandage. A soft tube called a Foley catheter is placed through your penis into your bladder. This tube ensures that your urine drains easily while your urinary tube heals. Do not worry; this catheter is temporary.
Your surgical team may also place a small surgical drain near the incision site to remove any extra fluid. This drain is usually removed before you leave the hospital.
As the anesthesia wears off, you will slowly wake up. You might feel a little groggy at first. Once you are fully awake, your care team will give you pain relievers to keep you comfortable.
When your doctors are confident in your recovery, you can go home. However, you may need to stay in the hospital for about a day.
Your doctor will schedule follow-up appointments over the next few months. During these visits, they may perform tests like an X-ray or a cystoscopy to make sure your urinary tube is healing properly.
You will wear the Foley catheter for 3 to 4 weeks, and all your urine will drain through it during this time. Once the catheter is removed, you should be able to urinate smoothly and easily, just like you did before your injury.
Benefits, Success Rates, and Risks
Like any surgery, posterior urethral reconstruction has important benefits along with a few risks to keep in mind.
| Category | Description |
|---|---|
| Benefits | You can finally urinate without straining, pain, or difficulty. Frequent urinary tract infections (UTIs) become much less common. Because your bladder empties completely, your kidney health is protected as well. |
| Success Rate | This surgery is highly successful. Studies show that when performed after a pelvic injury, success rates range between 92% and 97%. When performed after prostate cancer treatments, success rates range from 70% to 85%. |
| Side Effects and Risks |
Potential risks include:
|
Recovery Time and Self-Care Tips
Your active participation is crucial for a fast and safe recovery after surgery.
Pain Management
Most people experience mild to moderate discomfort. However, your doctor will give you prescription pain medicines to keep your pain well controlled.
Physical Activity
- Avoid driving and sitting for long periods until your catheter is removed (usually 3 to 4 weeks).
- Light walking and climbing stairs at a gentle pace are fine.
- Do not lift anything heavier than 20 pounds (9 kilograms).
- Avoid running, squatting, wide leg stretches, and twisting sports like golf for one to two months.
Sexual Activity
Avoid sexual intercourse and masturbation for at least 8 weeks to give your body enough time to heal.
Returning to Work or School
If you have a desk job, you can usually return to work in one to two weeks. If your job involves physical labor, you will need 6 to 8 weeks off.
When to Seek Emergency Medical Attention
Call your doctor or seek emergency medical care right away (or call 911 / 999) if you notice any of these warning signs after going home:
- You are completely unable to urinate.
- You see blood or blood clots in your urine one week after surgery.
- Your catheter stops draining urine or drains very slowly.
- Fluid, pus, or foul-smelling drainage leaks from your incision.
- You develop a fever, chills, or severe headache, which are signs of infection.
- Your pain gets worse and does not improve with your prescribed pain medicine.
- The surgical area swells greatly or becomes very red.
Dealing with an injury or cancer is already difficult. Facing a blocked urinary tube on top of that can feel overwhelming and stressful. But the good news is that posterior urethral reconstruction is a proven, highly successful treatment. This surgery can help you return to normal, comfortable urination and bring your life back on track.
💡 Take-Home Message
- Posterior urethral reconstruction is a very successful surgery designed to fix strictures in the back of your urinary tube.
- This condition is most commonly caused by severe injuries or prostate cancer treatments.
- Feeling anxious or worried about surgery is normal, but the main goal is to improve your health and quality of life.
- Following your doctor's instructions closely during your recovery period is essential for healing quickly.
- If you experience any trouble urinating or other unusual symptoms, talk to a doctor right away without delay.
No comments yet. Be the first to share your question or experience below.