Urethral stricture surgery
Restore a free and lasting urinary tract
How to treat urethral stricture? Dr. Davy Benarroche, urologist and andrologist surgeon, is an expert in urethral stricture surgery in Paris.
Urethral stricture surgery
What is urethral stricture? Urethral stricture is a narrowing of the urinary tract , which prevents urine from flowing normally from the bladder. It can occur after : trauma (fall on the perineum, urinary catheter, previous surgery), a past urethral infection , or, more rarely, in an inflammatory or congenital context. Symptoms are often progressive: decreased urinary stream , more frequent urination, a feeling of incomplete emptying, or even acute retention when the urethra is completely blocked.
Diagnosis
The diagnosis is based on : patient history and clinical examination , retrograde and voiding urethrography (X-ray with contrast agent), and urethroscopy to visualize the stricture. These examinations allow determination of the location, length, and degree of obstruction , essential for planning the treatment strategy.
Expertise
Urethral stricture
Dr. Benarroche supports patients with urethral stricture with personalized treatments, combining diagnostic expertise and surgical or endoscopic solutions depending on the complexity of the case.
Expertise - Qu'est-ce qu'une sténose de l'urètre ?Dr Davy Benarroche
Treatment options
Treatment depends on the length, location , and duration of the stricture . Two main approaches are used: endoscopic urethrotomy and urethroplasty . Endoscopic urethrotomy: a temporary or palliative treatment. Endoscopic urethrotomy involves incising the stricture from the inside using an endoscope inserted into the urethra. This technique, performed under anesthesia, is simple and minimally invasive , but it only treats the visible narrowing without correcting the underlying scarring. It is sometimes indicated for very short, partial, and non-recurrent strictures . However, in most cases, the stricture recurs within months , with an estimated failure rate of 60 to 80 % in the medium term. Repeated dilations or successive urethrotomies generally do not provide a lasting cure and can even worsen local fibrosis. Therefore, endoscopic urethrotomy should be considered as a temporary treatment or as an initial assessment before definitive reconstruction. Urethroplasty: the gold standard curative treatment. Urethroplasty is reconstructive surgery of the urethra. It involves removing or reconstructing the narrowed area to restore a normal caliber and a sustained flow. Depending on the case: Resection-anastomosis : the diseased segment is removed, and the two healthy ends are sutured. Urethroplasty with buccal mucosa graft : the mucosa of the cheek is harvested and used to widen the narrowed area. These techniques achieve success rates exceeding 85–90% , with a lasting return to a normal flow and restored quality of life . Urethroplasty is therefore the only treatment that allows for complete healing in cases of extensive, complete, or recurrent stricture.
Procedure and post-operative course
The procedure is performed under general anesthesia . A urinary catheter is left in place for a few days to a few weeks, depending on the technique. Regular post-operative follow-up is essential to monitor healing and prevent any recurrence.
Experience
Academic background
Dr. Benarroche offers care focused on men’s health , combining a medical and surgical approach, tailored to the needs of each patient.
Dr Davy Benarroche - Parcours académiqueDr Davy BenarrocheResults
In the vast majority of cases, patients regain a strong and continuous urinary stream , without any residual discomfort. Complications are rare, and a return to normal activities is rapid. Specialized follow-up ensures that the results are maintained long-term.
Dr. Davy Benarroche's expertise
Dr. Davy Benarroche , a urologist and andrologist, holds a university diploma in urethral surgery . He performs all treatments for urethral strictures, from simple endoscopic procedures to complex reconstructions with buccal mucosa grafts. His expertise allows him to offer personalized care, in accordance with the latest reconstructive surgery guidelines .
In summary
Urethral stricture is a scarring condition that does not heal spontaneously. While endoscopic urethrotomy can sometimes provide temporary relief, urethroplasty remains the gold standard treatment , the only one capable of providing a lasting cure .
Expert in urethral reconstruction.
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FAQ – Frequently Asked Questions
What are the signs of urethral stricture?
The main symptom is a progressive weakening of the urinary stream, with straining, prolonged urination, post-void dribbling, and sometimes recurrent urinary tract infections or retention. A simple uroflowmetry test quickly guides the diagnosis.
What are the causes of urethral strictures?
The most frequent causes are urethral trauma (catheterization, endoscopy, pelvic fracture, perineal trauma), past infections, and lichen sclerosus. Some strictures remain without an identified cause.
What treatments are possible?
Endoscopic urethrotomy is suitable for short strictures but carries a risk of recurrence. Urethroplasty—surgical reconstruction of the urethra, sometimes with buccal mucosa grafting—is the standard treatment for long or recurrent strictures, with a long-term success rate of over 85%.
What is a buccal mucosa graft?
A fragment of mucosa is taken from inside the cheek to widen the narrowed segment of the urethra. This tissue, naturally adapted to moist environments, offers excellent results. The buccal graft heals in about ten days.
Can a stenosis heal spontaneously?
No. Urethral stricture is a permanent fibrous scar. Only surgery can restore a normal diameter.
Is urethrotomy always sufficient?
No. Urethrotomy is often followed by a recurrence. In cases of complete, prolonged, or recurrent stenosis, urethroplasty should be considered.
Is oral mucosal transplantation painful?
Oral discomfort is moderate and transient, with rapid healing within a few days.
Urethral stricture surgery: there are solutions.