How Does the Recovery Process Progress After Urethroplasty Surgery?

Urethroplasty is considered one of the most successful open surgical methods for the permanent treatment of urethral stricture. However, it is important to remember that the success of the surgery itself is only one part of the process. How you manage the recovery period after urethroplasty also plays a major role in achieving long-term healing.

After surgery, our patients naturally have many questions, and the first ones are usually:

“When will I return to normal?”“Will I have a lot of pain?”“How long will I have to live with this catheter?”

In this article, we explain step by step what to expect in the weeks following surgery, from the first hours after the operation to catheter removal and long-term follow-up visits.

The First Days in the Hospital

After the effects of anesthesia wear off and you are taken to your room, you will usually be kept under general observation for the first 24–48 hours. During this hospital period after urethroplasty, the following points are carefully monitored:

Pain Management:One of the biggest concerns for patients is severe pain. However, significant pain in the surgical area is not expected after urethroplasty. In most cases, patients need very little standard pain medication and go through this period quite comfortably.

Catheter and Wound Care:A catheter will remain in place so that your urinary tract can adapt to its new structure. During your hospital stay, your urine output and wound area will be regularly monitored by our nurses.

Removal of the Dressing:The dressing on the surgical area is usually removed on the 3rd day. There is an important reason for this: during the procedure, tissue taken from inside the mouth, known as a graft, is often used to repair the urethra. In order for this new tissue to adapt to the perineal area, establish blood supply, and receive nourishment, the area must remain closed and immobile during the first 3 days.

Discharge and Bathing:After the dressing is removed on the 3rd day and the wound is checked, you are usually discharged on the 4th day if everything is progressing well. You may comfortably take a bath one week after surgery.

Recovery at Home and the Catheter Period

The First 2–6 Weeks

Once you return home, the main recovery period begins. During this home recovery phase after urethroplasty, there are several important rules you should follow:

Activity and Sitting Position:You may take short walks at home, which is beneficial for blood circulation. However, while sitting, you should be careful not to put pressure on the perineal area. Activities that apply direct pressure to this region, such as riding a bicycle or motorcycle, should definitely be avoided.

Nutrition and Oral Wound Care:If a graft was taken from inside your mouth during surgery, there will be a wound inside your cheek. To help this area heal quickly, you should avoid foods with sharp edges that may scratch the inside of the mouth, such as chips or hard-crusted bread. Drinking plenty of fluids is beneficial both for your general recovery and for your urinary tract. Also, if you use blood-thinning medication, you should strictly follow the dose and schedule recommended by your doctor.

Monitoring the Wound Area:You should keep the perineal wound area clean and watch carefully for signs of bleeding, redness, or infection.

Catheter Removal and Returning to Work:The catheter is usually removed 3 to 4 weeks after surgery. After the catheter is removed, your doctor will check the wound inside your mouth, the perineal area, and whether your urine flow is normal.

If everything is progressing well:

Patients who work at a desk or do light work can usually return to normal life and work within 2–3 weeks after catheter removal.

Patients who do physically demanding heavy work can usually return to normal life and work within 4–6 weeks.

What Is Checked During Follow-Up After Urethroplasty?

It feels wonderful when your urine flow returns to normal after the catheter is removed, but the process does not end there. The long-term success of urethroplasty depends on regular follow-up. The long-term success rate of urethroplasty surgery is quite high, around 85–95%.

Follow-Up Schedule:After catheter removal, routine follow-up visits are usually scheduled in the 1st month, 3rd month, and 6th month.

Tests Performed:The most important test during these follow-ups is uroflowmetry, which measures urine flow rate. In addition, a urine test and urine culture are performed to rule out a possible infection.

Signs of Recurrence and Further Tests:A weakening of the urine stream or pressure during urination is the most important warning sign of recurrence. If your urine flow rate during follow-up is slower than expected, below 15 ml/sec, procedures such as retrograde urethrography, a contrast X-ray, or urethroscopy, an examination with a camera, may be required to assess the condition of the stricture.

Frequently Asked Questions

Is burning during urination normal after catheter removal?Yes, it is normal. In the first few days after the catheter is removed, mild burning, stinging during urination, and a frequent urge to urinate are expected. These complaints usually improve on their own within a few days. However, if the burning sensation increases instead of decreasing, you should contact your doctor.

When can sexual activity resume after urethroplasty surgery?Depending on your healing process, sexual activity may resume after catheter removal with your surgeon’s approval.

Can swelling or bruising occur in the surgical area?Yes. Temporary swelling and color changes, such as bruising, may occur in the perineal area and scrotum. These are part of the body’s healing response and usually gradually decrease within a few weeks. However, if you notice significant redness, intense warmth, or pus-like discharge from the wound area, you should contact your doctor without delay.

How Should Oral Care Be Performed After Buccal Mucosa Graft?

In open urethroplasty surgery for urethral stricture, tissue taken from the inside of the cheek, known as a buccal mucosa graft, is often used to widen and repair the narrowed area. Since oral tissue is naturally accustomed to a moist environment, it adapts very well to the urinary tract.

The oral mucosa is one of the fastest-healing tissues in the body. However, when a graft is taken from this area, patients must follow some important rules regarding eating, drinking, and oral hygiene during the first few weeks.

1. Nutrition: What to Eat and What to Avoid

In the first days after surgery, sensitivity and mild swelling inside the mouth are expected. To speed up healing of the new tissue and prevent bleeding, you should temporarily adjust your eating habits:

Consume Soft and Liquid Foods:During the first week, choose soft foods that are easy to chew, such as soup, yogurt, mashed foods, warm broth, pudding, and bananas.

Avoid Excessively Hot or Cold Foods:Make sure foods and drinks are at room temperature or lukewarm.

Sharp and Hard Foods Are Not Allowed:Foods with sharp edges, such as chips, toasted bread crusts, nuts, and crackers, may rub against the wound area and cause bleeding or pain.

Spicy and Acidic Foods:Lemon, orange juice, vinegar, hot peppers, and heavily spiced foods should not be consumed during the healing period, as they can cause a strong burning sensation on the open wound.

2. Oral Hygiene and Brushing

Keeping the inside of the mouth clean is critical for preventing a possible infection.

Mouthwash:You may use alcohol-free mouthwashes or antiseptic solutions prescribed by your doctor, usually 2–3 times a day.

Tooth Brushing:You may continue brushing your teeth, but you should use a soft-bristled toothbrush and must not touch the wound area, the inner cheek where the graft was taken, with the brush.

3. Pain, Swelling, and Speaking

Pain:During the first few days, mild soreness may be felt while swallowing or speaking. The prescribed painkillers will help you get through this period more comfortably.

Swelling and Numbness:There may be mild swelling and numbness on the cheek side where the graft was taken, which may also be visible from the outside. This usually resolves on its own within 1–2 weeks.

Opening the Mouth Wide:As healing tissue, or scar tissue, forms, you may have difficulty opening your mouth fully. This is a temporary tightness. As healing is completed, your mouth opening will return to normal.