Urethroplasty in Korea

Urethroplasty is a highly specialized reconstructive surgical procedure to repair and reconstruct the urethra, most commonly performed to treat urethral strictures that are long, complex, or have recurred after less invasive treatments. In Korea, expert urological reconstructive surgeons perform urethroplasty using various advanced techniques, offering a durable and often definitive solution for patients suffering from persistent urethral narrowing.

Understanding Urethral Strictures & Indications in Korea

Urethral strictures are scar tissue formations that narrow the urethra, significantly impeding urine flow.

• Causes: Frequently caused by trauma (e.g., straddle injuries, catheterization), infection (e.g., STIs), or prior surgery. Some cases are idiopathic.
• Symptoms: Include weakened or spraying urine stream, difficulty urinating, painful urination, frequent urges, incomplete bladder emptying, and recurrent urinary tract infections (UTIs).
• Indications for Urethroplasty: Considered the gold standard for:
• Long or Complex Strictures: Where dilation or urethrotomy is unlikely to be successful.
• Recurrent Strictures: After failure of previous endoscopic treatments (dilation, urethrotomy).
• Strictures in specific locations: Such as penile or membranous urethra strictures, which often respond poorly to less invasive methods.
• Diagnosis: In Korea, diagnosis involves a comprehensive evaluation including uroflowmetry, urinalysis, retrograde urethrography (RUG) to visualize the stricture length and location, and sometimes urethroscopy.

Common Surgical Techniques in Korea

Urethroplasty techniques are chosen based on the stricture's location, length, and severity.

• Excision and Primary Anastomosis (EPA): Best for short strictures (typically <2 cm) in the bulbar urethra, where the narrowed segment is removed and healthy ends are rejoined. High success rates.
• Buccal Mucosa Graft Urethroplasty: Used for longer strictures, especially in the penile or bulbar urethra. Tissue from the inner cheek is harvested and used to widen the opened urethra. High success rates with good tissue viability.
• Flap Urethroplasty: Less common now, uses local skin (penis/scrotum) for reconstruction in specific long/complex strictures.
• Staged Urethroplasty: For very complex strictures or multiple failures, performed in two or more stages.

Recovery & Outcomes in Korea

Urethroplasty is a significant surgery with a relatively longer recovery but excellent long-term results.

• Hospital Stay: Typically 3-7 days.
• Catheterization: A urinary catheter (often suprapubic) is kept for 3-4 weeks for healing.
• Recovery: Light activities in weeks; full recovery takes 6-12 weeks.
• Success Rates: High long-term success (over 80-90% for primary repairs), much better than endoscopic methods for complex strictures.
• Complications: Risks include infection, bleeding, fistula, or recurrence (lower risk than other methods).

Korean Guidelines & Practice

Korean urological reconstructive surgeons are highly skilled in urethroplasty.

• Specialized Expertise: Performed by urologists with advanced training in reconstructive urology.
• Gold Standard: Recognized as the definitive treatment for suitable urethral strictures, particularly recurrent or complex ones.
• Advanced Centers: Major university hospitals and specialized centers in Korea offer comprehensive urethroplasty programs.
• Patient Counseling: Detailed discussions about the surgical plan, recovery, and long-term expectations are provided.
• National Health Insurance: Urethroplasty for medically indicated urethral strictures is generally covered by Korea's national health insurance.

Key Takeaways for Urethroplasty in Korea

To summarize the essential points about Urethroplasty in Korea:

• Definitive Stricture Repair: Reconstructive surgery for long, complex, or recurrent urethral strictures.
• Various Techniques: Includes excision and primary anastomosis, and buccal mucosa graft urethroplasty.
• High Success Rates: Offers durable long-term outcomes, significantly reducing recurrence.
• Specialized Surgery: Performed by expert urological reconstructive surgeons in advanced centers.

We hope this guide clarifies Urethroplasty in Korea. Always consult a qualified medical professional for personalized advice, diagnosis, and treatment options for urethral strictures.