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Treatment in Clifton, NJ

Urethroplasty

Reconstruct & Restore Urinary Flow

Introduction to Urethroplasty

Difficulty urinating can become an ongoing problem for people with a urethral stricture, particularly when previous treatments have not provided the desired improvement. Urethroplasty offers a surgical approach to address the narrowed area and reconstruct the urethra.

At East Coast Advanced Urology in Clifton, NJ, Dr. Karl Coutinho performs urethroplasty for patients with urethral strictures and other complex reconstructive needs. Fellowship-trained in genitourinary trauma and reconstruction, he evaluates the location, length, and cause of the stricture when determining the appropriate surgical approach.

Dr. Coutinho welcomes patients from throughout the greater New York metropolitan area and develops individualized treatment plans based on each patient’s condition and previous treatment.

Urethroplasty-intro

What Is Urethroplasty?

A urethral stricture develops when scar tissue causes part of the urethra to become narrowed. Strictures can develop after an injury, infection, previous procedure, or other damage to the urethra and may interfere with normal urine flow. Some patients are born with a predisposition to strictures due to inadequate prenatal development of the tissue around the urine channel.

Urethroplasty is reconstructive surgery used to repair the narrowed portion of the urethra. The specific technique depends on factors such as the stricture’s location and length. In some cases, the scarred segment can be removed, and the healthy ends of the urethra reconnected. This is generally the case with short strictures and strictures closer to the bladder. Other repairs may require tissue grafting to reconstruct the urine channel or widen the affected area, especially if the stricture is long or in the penile portion of the urine channel.

Dr. Coutinho will determine the appropriate approach after evaluating the stricture and your treatment history. This often involves in-office procedures such as cystoscopy or additional procedures such as a retrograde urethrogram.

Related Urologic and Reconstructive Care

Patients with urethral strictures may sometimes have additional urinary or reconstructive concerns that require evaluation. Dr. Coutinho can determine whether another condition should be addressed as part of your overall urologic care.

Patients experiencing erectile dysfunction can discuss these concerns with Dr. Coutinho. He can evaluate erectile function and discuss treatment options based on your symptoms, health, and individual needs.

Who Are the Best Candidates for Urethroplasty?

Urethroplasty may be considered when a urethral stricture requires surgical reconstruction. Dr. Coutinho will evaluate the location, length, and cause of the stricture, along with your symptoms, health, and previous treatment, before recommending surgery.

Patients who may be candidates include those who:

  • Have a recurrent urethral stricture
  • Have a longer or more complex area of narrowing
  • Have a stricture related to trauma or previous surgery
  • Have urinary symptoms caused by significant urethral narrowing
  • Are appropriate candidates for reconstructive surgery and anesthesia

What Are the Benefits of Urethroplasty?

Urethroplasty addresses the narrowed portion of the urethra through surgical reconstruction. It may be considered for patients with recurrent, longer, or more complex strictures, including those who have undergone previous treatments. For recurrent anterior urethral strictures after a prior dilation or internal urethrotomy has failed, AUA guidance generally favors urethroplasty over repeated endoscopic treatment when a long-lasting reconstruction is appropriate. Penile strictures and longer or more complex strictures are also situations in which open reconstruction is often preferred.

Potential benefits include:

  • Addressing scar tissue that is narrowing the urethra
  • Creating a wider pathway for urine to pass
  • Reducing the rates of infections, fistula, bladder dysfunction, and other sequelae of stricture disease
  • Treating strictures that have returned after previous procedures such as dilation
  • Reducing the need for repeated dilation or other temporary treatments in appropriate patients
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How to Begin Your Urethroplasty Journey

Evaluation begins with a consultation with Dr. Coutinho at East Coast Advanced Urology in Clifton, NJ. He will review your symptoms, prior procedures, and urethral anatomy to determine whether urethroplasty or another treatment is appropriate.

Patients can expect to:

  • Discuss urinary symptoms and how they have changed over time
  • Review previous procedures, injuries, or treatments involving the urinary tract
  • Go over your medical history and current medications
  • Complete any recommended imaging or diagnostic evaluation such as cystoscopy and retrograde urethrogram
  • Discuss the location and extent of the urethral stricture
  • Review the surgical approach that may be appropriate for your condition
  • Receive personalized instructions for preparing for surgery

What to Expect on the Day of Urethroplasty

Before surgery, Dr. Coutinho and the care team will review your treatment plan and answer any remaining questions. Urethroplasty is performed with anesthesia, and the surgical approach will depend on the location, length, and complexity of your urethral stricture. The procedure generally takes 1.5 to 3 hours and can be done in a hospital or surgical center. Most patients go home on the same day as surgery.

During surgery, Dr. Coutinho repairs or reconstructs the narrowed portion of the urethra using the technique selected for your condition. Depending on the stricture, this may involve removing scarred tissue and reconnecting the urethra or using a tissue graft to reconstruct the affected area. Often, surrounding tissue is brought over the repaired area to provide additional blood supply and help protect against further strictures or fistula formation.

A urinary catheter is typically used after urethroplasty to drain urine while the reconstructed urethra begins to heal. Dr. Coutinho will provide instructions for catheter care and determine when it can be removed based on your procedure and recovery.

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Urethroplasty Recovery

Your Guide to Post-Urethroplasty Care

Recovery after urethroplasty will depend on the type and extent of reconstruction performed. A urinary catheter is generally kept in place while the urethra begins to heal, and Dr. Coutinho will determine when it can be removed based on your procedure and follow-up evaluation.

You will receive personalized instructions regarding catheter care, medications, activity, hygiene, and other precautions. Certain activities, including strenuous exercise, heavy lifting, and sexual activity, may need to be limited during the initial healing period.

Follow-up care allows Dr. Coutinho to evaluate the reconstructed urethra, monitor your recovery, and determine when you can gradually return to your usual activities.

How Much Does Urethroplasty Cost in New Jersey?

Urethroplasty is customized according to the type of reconstruction required. After Dr. Coutinho evaluates your urethral stricture and develops a surgical plan, our team can provide more information about the anticipated costs of your care.

Insurance benefits vary by plan; however, most insurances cover urethroplasty. The office can help you review your coverage and understand any financial responsibility you may have before surgery. You should always verify your cost and coverage with your specific insurance carrier and plan.

Why Choose Dr. Coutinho?

Dr. Karl Coutinho is a fellowship-trained reconstructive urologist in Clifton, NJ, with advanced training in urethral reconstruction, genitourinary trauma, and other complex urologic conditions. He completed his general surgery internship and urology residency at Mount Sinai Hospital in New York City before pursuing fellowship training in genitourinary trauma and reconstruction at Northwestern Memorial Hospital in Chicago and the University Hospitals of Cleveland.

Dr. Coutinho has also completed additional training in genitourinary prosthetics and reconstruction through Perito Urology in Miami and as a visiting fellow at the Kulkarni Endosurgery Institute. His background in reconstructive urology allows him to evaluate urethral strictures by location, complexity, cause, and prior treatment when developing a surgical plan.

He welcomes patients from throughout the greater New York metropolitan area and provides individualized care for patients requiring urethral reconstruction.

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Urethroplasty FAQ’S

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Patient Reviews

  • My surgery was life changing and the recovery period was better than I ever expected. I would highly recommend Dr Coutinho , he is the best.

    View Gallery Claude R.

  • I had an outstanding experience with Dr. Coutinho and their entire urology team. They truly go above and beyond.

    View Gallery Jenney S.

  • Dr Karl Coutinho is an excellent doctor in his field. He made me feel whole again after doing two procedures for me.

    View Gallery Keith A.

  • I’ve never met a doctor so empathetic

    I’ve never met a doctor so empathetic, professional and Knowledgeable Dr Coutinho performed a very difficult surgery on me. I had absolutely no pain.

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Patient Reviews

East Coast Advanced Urology

Schedule Your Consultation

If a urethral stricture is causing difficulty urinating or has returned after previous treatment, schedule a consultation with Dr. Karl Coutinho at East Coast Advanced Urology in Clifton, NJ. He can evaluate the stricture, review your previous treatment, and determine whether urethroplasty or another approach may be appropriate.

Dr. Coutinho welcomes patients from throughout the greater New York metropolitan area. Call today to schedule your consultation.

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