Urethroplasty
Open urethral surgery (urethroplasty) is the only treatment that achieves over a 95% success rate for curing urethral strictures
Urethral Reconstruction Techniques
The techniques for joining severed ends (urethral anastomosis) differ from those used to widen the internal lumen (urethral augmentation). In our practice, we encounter severe cases of urethral strictures, with the most commonly performed procedure being urethral reconstruction using a buccal mucosa graft (BMG urethroplasty).
Post-Traumatic Urethral Stricture Treatment
For urethral strictures resulting from traffic accidents, we employ a perineal approach, involving scar tissue removal and direct anastomosis of the damaged urethral segments.
Perineal Urethrostomy
A perineal urethrostomy—creating a urethral opening in the skin below the scrotum—is rarely used as a treatment option for urethral strictures. It is reserved for extremely complex cases where urethral reconstruction is not feasible.
Urethrography
Urethrography is a diagnostic procedure performed as part of preoperative preparation for urethral reconstruction. This outpatient procedure involves introducing iodine contrast into the urethra and taking X-ray images during both filling (retrograde urethrography) and voiding (voiding cystourethrography). The procedure lasts about 20 minutes and is completely painless.
Urethroscopy
In addition to urethrography, urethroscopy is essential for intraoperative assessment of the stricture. This procedure is performed under anesthesia.
Urethroplasty Procedure
Urethroplasty is typically performed under general anesthesia, though regional (spinal) anesthesia may also be used. The surgery usually lasts up to 2 hours. Hospital discharge is on the next day. Outpatient check-ups are every 2–3 days post-op. Catheter remains in place for about 2 weeks, after which it is removed, and natural voiding through the urethra begins.
Microsurgical Advantages
By applying microsurgical techniques, we achieve exceptional precision in urethral reconstruction and excellent long-term outcomes, minimizing the risk of stricture recurrence.
Key Terminology:
Anastomosis = Surgical connection of two structures.
Augmentation = Surgical widening/enlargement.
Buccal mucosa graft (BMG) = Tissue taken from the inner cheek for reconstruction.
Perineal approach = Surgical access via the perineum (between scrotum and anus).
Voiding cystourethrography (VCUG) = Imaging during urination.
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Below are clinical images and procedural videos from actual surgeries
Uretralna Hirurgija
Hirurgija suženja uretre - Najbolja operacija pomoću sluzokože iz usne duplje (uretroplastika)
Rekonstrukcija membranoznog dela uretre nakon saobraćajne traume - fraktura karlice i stenoza uretre
Operacija dugačkog suženja uretre - Panuretralna uretroplastika pomoću grafta bukalne mukoze
Rekonstrukcija suženja bulbarne uretre - Uretroplastika sa graftom bukalne mukoze (BMG dorsal onlay)
Treatment of Bulbar Urethral Stricture – Buccal Mucosa Graft Urethroplasty
Urethrography Reveals Bulbar Urethral Injury
dr Nikola Stanojevic
Intraoperative Urethroscopy
dr Nikola Stanojevic
dr Nikola Stanojevic
Definitive Treatment of Urethral Stricture Using Buccal Mucosa Graft (BMG Urethroplasty)
There are no visible scars, and the patient urinates normally two weeks after the surgery
dr Nikola Stanojevic
Single-Stage Panurethral Stricture Repair Using Extended Buccal Mucosa Graft
Urethrography shows damage to the entire urethra
dr Nikola Stanojevic
Buccal Mucosa Graft Transplantation for Urethral Reconstruction
dr Nikola Stanojevic
Definitive Reconstruction of the Entire Urethral Canal Using Buccal Mucosa Graft
dr Nikola Stanojevic
