✦ Urethral Stricture Treatment

Staged Urethroplasty

Q: Why does staged urethroplasty take two operations?

The first stage establishes a healthy vascularised urethral plate; the second stage tubularises it — ensuring better healing and lower failure rates.

Q: How long between the two stages?

At least 6 months are required for the buccal mucosa graft to fully mature and develop adequate vascularity for tubularisation.

Q: Can I urinate normally between the two stages?

Patients void via a perineal urethrostomy between stages; this is temporary and planned as part of the reconstructive process.

Two-Stage Urethral Reconstruction for Complex or Failed Cases

90–180 min per stage PROCEDURE

2–4 Days per stage HOSPITAL STAY

>80% SUCCESS RATE

6–12 Months total RECOVERY

What is Staged Urethroplasty?

Staged Urethroplasty is a two-stage reconstructive procedure used for complex, long, or lichen sclerosus-affected urethral strictures where single-stage reconstruction is not feasible. In the first stage, the urethra is laid open and a graft (usually buccal mucosa) is quilted onto the perineum as a new urethral plate. In the second stage (typically 6 months later), the plate is tubularised into a neourethra. The procedure is performed under general or spinal anaesthesia with a hospital stay of 2–4 Days per stage. Success rates reach >80% in appropriately selected patients at experienced centres.

Patients with complex panurethral strictures, lichen sclerosus, severely scarred urethra, or failed prior urethroplasty not amenable to single-stage repair. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Stage 1 — Urethral Marsupialization & Graft

In the first stage, the diseased urethra is laid open (marsupialized) and a buccal mucosa graft quilted onto the perineal skin to form a urethral plate.

Inter-Stage Voiding

After the first stage, the patient voids via the marsupialized urethral plate directly into a perineal opening.

Plate Maturation

At 6–12 months, the urethral plate is assessed for adequate vascularity and maturation before proceeding to Stage 2.

Stage 2 — Tubularisation

Tubularisation of the urethral plate is performed by elevating the plate from the perineal skin and closing it into a tube over a catheter.

Wound Closure & Catheter

The skin closure is completed in layers with the bulbospongiosus muscle re-approximated where possible; catheter left for 3–4 weeks.

Outcomes

90–180 min per stageDURATION

2–4 Days per stageHOSPITAL STAY

>80%SUCCESS RATE

6–12 Months totalFULL RECOVERY

Who Needs This Treatment?

→Developed specifically for complex, long, or lichen sclerosus-affected strictures not suitable for single-stage repair.
→The inter-stage interval of 6–12 months allows complete graft vascularisation before tubularisation.
→Used for all complex urethral reconstruction including panurethral, failed prior repairs, and hypospadias cripples.
→Patient counselling must address the total timeline — two operations and 6–12 months between stages.
→Success rates in experienced centres exceed 80% even for the most complex strictures.
→Staged approach reduces failure risk compared to attempting single-stage repair in unsuitable anatomy.

"Staged urethroplasty is reserved for our most challenging cases — failed prior repairs, lichen sclerosus, and panurethral disease. With patience and careful planning, outstanding functional results are achievable."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Why does staged urethroplasty take two operations?+

How long between the two stages?+

Can I urinate normally between the two stages?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

WhatsApp Us ← Back to Treatments