Urethral stricture is a narrowing of the urethra, usually caused by scarring after inflammatory diseases, surgical interventions, or procedures. Depending on the location, strictures can be prostatic, membranous, bulbous, penile, or capitate. Strictures up to 2 cm are considered to be short and those with a size exceeding 2 cm are considered to be long. The methods of their treatment differ. It would be a perfect option to go to one of the hospitals in Germany to get rid of urethral stricture once and for all. With the help of the Booking Health service, you can choose the most suitable medical centers.
Content
- Healing surgical procedures
- Palliative surgical interventions and procedures
If the narrowed area is small, the affected part of the urethra can be simply removed, and the ends will be sutured. Strictures with a large length require a reconstructive stage: a part of the urethra is restored with its own tissues or synthetic materials. If urethroplasty is contraindicated, doctors perform palliative procedures such as urethral bougienage or endoscopic urethrotomy.
You can undergo your treatment at one of the following hospitals: University Hospital of Ludwig Maximilian University of Munich, Urology Clinic Munich-Planegg, or University Hospital Ulm.
We will take care of the arrangements for your trip if you make your treatment appointment through the Booking Health service. A medical advisor from the Booking Health company will select a hospital, a doctor, and a treatment method for you. The Booking Health manager will make an appointment on the preferred date, help you to apply for a visa, take care of the airline tickets and transfer, provide you with a medical interpreter, and stay in touch with you 24/7.
Healing surgical procedures
Most men want to get rid of urethral stricture forever, but not for a few months or years. The following operations can be used for a complete cure:
End-to-end anastomotic urethroplasty. A doctor removes the narrowed area and sutures the ends. The technique can be used for strictures up to 2-4 cm in any location except for the penile one (healthcare professionals can treat strictures of the bulbous, prostatic, and membranous sections). Doctors try to suture the ends of the urethra without tension whenever possible. The best results can be achieved in strictures up to 2 cm. If the length is greater, the risk of stricture recurrence and penis deformity increases.
Augmentation urethroplasty. This is a resection with reconstruction. The removed fragment of the urethra is restored from other tissues. This is the preferred treatment option for urethral stricture in Germany with a penile location or a size of more than 2 cm. There are a great number of surgical techniques. The fixation method can be an onlay, insert, or anastomosis. Plastic surgery with an onlay, depending on where it is attached, can be dorsal, ventral, or lateral. Doctors can perform plastic surgery using the buccal mucosa, a skin flap, and sometimes artificial materials. In the case of penile strictures, doctors often use dorsal onlay plastic patches.
Replacement urethra plastic surgery. This is a multi-stage treatment method. Doctors form a new part of the urethra. The technique can be used only for the most severe cases of the disease: in a long stricture, significant cicatricial changes, or concomitant Lichen sclerosus. The technique is often used to treat urethral strictures that develop after surgery for hypospadias. A patient requires at least two operations with a break of six months or more.
Palliative surgical interventions and procedures
Palliative interventions are more sparing, have a minimum of contraindications, and do not require long-term rehabilitation, but only provide a temporary improvement.
Urethral bougienage. This is the method of dilating the lumen of the urethra by gradually expanding the bougie with an increasing diameter or balloon, which is inflated from the inside. The procedure is indicated for men who, for some reason, cannot undergo surgery at the moment (for example, due to medical contraindications).
Endoscopic internal urethrotomy (Sachse method). A doctor dissects the narrowed section of the urethra under the guidance of an endoscope. The specialists can use various energies, such as a laser. The procedure is effective for bulbous urethral strictures up to 1 cm long. It has a high recurrence rate. In the case of a recurrence, the procedure can be repeated. If another recurrence occurs, then another treatment method will be used. Endoscopic internal urethrotomy cannot be performed for strictures of more than 1 cm or in the case of the location of even short strictures in the penile (located inside the penis) part of the urethra.
Perineostomy. This is a surgical procedure to form a perineostoma, an opening for the output of urine to the perineum. This treatment option can be used in patients with contraindications to surgery who need to rapidly divert urine.
You are welcome to use the Booking Health service to undergo your diagnostics and treatment of urethral stricture in Germany. On the website, you can make your appointment at the German clinic at a favorable price. You can simply select the disease from the search list and the treatment method, for example, bougienage, urethroplasty, or transurethral splint. You can also compare the cost of medical services in different hospitals and choose the option that suits you best. Our specialists will help you to select the most suitable clinics in Germany and arrange your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
MedlinePlus
The Lancet
