Name of the Procedure:

Urethrorrhaphy, suture of urethral wound or injury; penile

Summary

Urethrorrhaphy is a surgical procedure performed to repair a wound or injury to the urethra, specifically in the penile area. The procedure involves suturing the damaged tissue to restore the normal structure and function of the urethra.

Purpose

Urethrorrhaphy addresses injuries or wounds to the penile urethra, which can result from trauma, accidents, or certain medical conditions. The goals of the procedure are to repair the urethral damage, ensure proper urinary function, prevent infections, and restore the integrity of the penile urethra.

Indications

• Penile trauma leading to urethral injury
• Urethral lacerations or tears
• Post-surgical complications involving the penile urethra
• Severe inflammation or infection causing urethral damage

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Adjustment or cessation of certain medications as directed by the physician.
• Pre-procedure diagnostic tests such as urinalysis, urethral imaging (e.g., urethrography), and blood tests to assess overall health.

Procedure Description

1. The patient is placed under general or regional anesthesia to ensure comfort.
2. The surgical site is cleaned and prepped.
3. A small incision is made to access the injured area of the penile urethra.
4. The surgeon carefully sutures the urethral wound or tear using fine, absorbable stitches to promote healing and minimize scarring.
5. Hemostasis is achieved to control any bleeding.
6. The incision is closed, and sterile dressings are applied.

The procedure utilizes specialized surgical tools such as fine suturing needles and magnification to ensure precision.

Duration

The procedure typically takes 1-2 hours, depending on the extent of the injury.

Setting

Urethrorrhaphy is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Urologist or specialized surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologist

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Stricture (narrowing) of the urethra
• Urinary incontinence
• Recurrence of urethral injury
• Adverse reactions to anesthesia

Benefits

• Restoration of normal urinary function
• Reduced risk of infections and further complications
• Healing of the urethral injury or wound
• Improved quality of life

Recovery

• Patients might need to stay in the hospital for a short period for observation.
• Pain management with prescribed medications.
• Avoidance of strenuous activities for several weeks.
• Follow-up appointments to monitor healing and remove any non-absorbable sutures, if used.
• Possible use of a urinary catheter temporarily to ensure proper drainage and healing.

Alternatives

• Non-surgical management with catheterization, though less effective for severe injuries.
• Endoscopic procedures to manage minor urethral injuries.
• Application of topical medications combined with close monitoring.

Alternative treatments might be less invasive but may not provide the definitive repair achieved through urethrorrhaphy, especially in cases of significant injury.

Patient Experience

• The patient will be under anesthesia during the procedure and should not feel any pain.
• Mild to moderate discomfort and swelling post-procedure are common, managed with prescribed pain medication.
• Urination might be slightly uncomfortable initially, but this typically improves within a few days.
• Following post-operative care instructions is crucial for a smooth recovery.