Dr. Rahul Yadav is one of the best open urological surgeon with a successful career of more than a decade.
WHAT IS OPEN UROLOGICAL SURGERY?
This is traditional surgery where an incision is made to access the area of the body that requires treatment. A Urologic condition is any disease or disorder that affects the male reproductive organs or the male and female urinary tract (kidneys, bladder, ureters and urethra).
To name a few, Open Urological surgery includes Bilateral Orchidectomy (removal of testis in case of proven Prostate cancer), AV fistula for Dialysis access in kidney failure patients and Urethroplasty for Urethral stricture
Urethroplasty is an open reconstructive procedure that has been used to treat strictures. In all cases, the choice of repair is based on the location and length of the stricture. No single repair is right for all cases. There are broadly 2 main types of Urethroplasty- Anastomotic urethroplasty and Substitution urethroplasty.
This method is usually reserved for short urethral strictures. In this case, a cut is made between the scrotum and rectum. The urethra can then be reconnected after removing the stricture. Hospital stay is between 2 to 4 days in such case. A catheter is left for 10 to 21 days.
When the stricture is long, the tissue can be transferred to replace the section that had the stricture. In difficult cases, substitution repairs may need to be done in stages. These repairs should be done by a urologist experienced with these surgeries. Overall the success rates are very good. The 3 kinds of substitution procedures are:
- Free graft (Penile or Buccal Mucosal)
- Penile Skin flap
This method replaces or enlarges a section of the urethra using your own tissue. The tissue may be skin (taken from the shaft of the penis) or, more often, buccal mucosa (taken from inside the cheek). After surgery, you may need a short hospital stay and has a catheter in situ for 2 or 3 weeks.
Penile Skin Flap
With this surgery, flaps of skin are rotated from the penis to create the new section of the urethra. This is needed when a graft needs to be long, and the stricture is severe. These procedures are complex and should be done by done by a trained Urologist/Urethroplasty surgeon. After surgery, you may need a short hospital stay and use a catheter for 2 or 3 weeks.
This method is used when stricture is long with dense fibrosis and multiple previous failed repairs.
First stage – The Stricture part of the urethra is opened, which shows the full length of the stricture. A graft is secured to the opened urethra. During that time, you will urinate through a new opening behind the stricture. This may mean that you have to sit down to urinate while the graft heals.
Second stage – After 6 weeks to 3 months of the first stage, the graft is formed into a tube. The urethra, then returns to normal. A small, soft catheter is left on the penis for 10 to 21 days.
Dr. Rahul Yadav is the best urologist in Lucknow (UP) India for all these procedures for patients where it is indicated.