Urethral stricture & genitourinary fistula
Urethroplasty and fistula repair, including redo cases referred after a previous repair has failed.
What it is
A urethral stricture is scar tissue narrowing the water pipe. Stretching or cutting the narrowing is quick and often works for a while, but the scar frequently comes back — repeated dilatation can make the eventual reconstruction harder.
A genitourinary fistula is an abnormal connection between the urinary tract and another structure, usually causing continuous leakage. Both problems are reconstructive rather than endoscopic questions, and both are better planned once than attempted repeatedly.
Symptoms you may notice
- A weak, spraying or split urinary stream
- Straining, with a long time to empty
- Recurrent urinary infections
- Continuous leakage of urine, day and night (fistula)
- Leakage of urine into the vagina (fistula)
- Pain or swelling along the urethra
- Symptoms that return within months of a previous procedure
Get seen promptly if
- Continuous incontinence after pelvic or obstetric surgery
- Inability to pass urine at all
- Repeated dilatations with progressively shorter benefit
How it is assessed
- Uroflowmetry with post-void residual
- Retrograde urethrogram and micturating cystourethrogram
- Flexible cystoscopy to define the narrowing
- Dye studies and CT/MR imaging to map a fistula tract
- Operative notes from any previous surgery
What the options actually involve
Other conditions
Urinary infection & recurrent UTI
A single infection is usually simple. Infections that keep coming back are a different question, and the answer is rarely another course of antibiotics.
Symptoms and treatmentKidney failure & transplant assessment
When kidney function falls far enough to need dialysis or a transplant, the decision is about timing as much as technique.
Symptoms and treatmentKidney & ureteric stones
From a single calculus to complex staghorn and multi-tract stone burdens, cleared by the least invasive route that will actually work.
Symptoms and treatmentHave a scan or report about this already?
Send it before your appointment. The consultation then starts from your findings rather than from scratch.