Name of the Procedure:

Urethromeatoplasty with Mucosal Advancement

Summary

Urethromeatoplasty with mucosal advancement is a surgical procedure to widen the opening of the urethra by using tissue from the surrounding mucosa. This procedure typically aims to improve urine flow and ease the process of urination.

Purpose

The procedure addresses a condition known as meatal stenosis, where the opening of the urethra is abnormally narrow. The goal is to enlarge this opening to facilitate better urine flow, reduce discomfort, and prevent urinary tract infections.

Indications

• Difficulty urinating
• Pain during urination
• Recurrent urinary tract infections
• Noticeable narrowing of the urethral opening
• Any structural abnormalities affecting the lower urinary tract, specifically the urethral meatus

Preparation

• Patients may be instructed to fast for a few hours prior to the procedure.
• Certain medications may need to be adjusted or paused.
• Diagnostic tests such as urine flow studies or uroflowmetry might be required to assess the severity of the condition.
• Physical examination to evaluate the urethral meatus and any related structures.

Procedure Description

1. Anesthesia is administered, typically local or general, depending on patient and procedural needs.
2. The surgeon makes an incision to expose the narrowed part of the urethra.
3. Tissue from the surrounding mucosa is advanced and used to reconstruct and widen the urethral opening.
4. Sutures are placed to secure the new opening, ensuring a wider and functional passage.
5. The area is thoroughly irrigated and cleansed to avoid infections.

Duration

The procedure generally takes around 30 minutes to 1 hour.

Setting

The procedure is usually performed in an outpatient clinic or a surgical center.

Personnel

• Urologist or specialized surgeon
• Anesthesiologist
• Surgical nurses

Risks and Complications

• Infection
• Bleeding
• Scarring
• Recurrent meatal stenosis
• Pain or discomfort during recovery
• Urinary retention or incontinence (rare)

Benefits

• Improved urine flow
• Reduced pain during urination
• Decreased incidence of urinary tract infections
• Enhanced quality of life due to relief from symptoms

Recovery

• Patients might experience mild discomfort or swelling post-procedure.
• Pain can be managed with prescribed medications.
• Avoid strenuous activities for several weeks.
• Follow-up appointments are necessary to monitor healing and ensure the success of the procedure.
• Patients are usually advised to maintain good hygiene to prevent infections.

Alternatives

• Dilatation: temporary stretching of the urethra, which may require repeat procedures.
• Topical steroid ointments: can help relieve narrowing but usually less effective for moderate to severe cases.
• Observation: for minor cases that do not significantly affect urination.

Patient Experience

Patients might feel a mild to moderate discomfort or pain post-surgery, which can be managed with medication. They should expect some swelling and sensitivity around the surgical site, but these symptoms generally subside within a few weeks. Regular follow-up care and adherence to post-operative instructions significantly contribute to a smooth recovery process.