IndianHealthGuru Consultants

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Indian Health Guru Medical trip planner & Manager in INDIA

Urethroplasty Surgery in India

Overview:

Urethroplasty is an operation for the repair of an injury or a defect in the walls

of the urethra. This surgical procedure is conducted to correct scar tissue

blockage of the urethra called urethral stricture. The urethra is the tube that

carries urine from the bladder (through the penis in males) to the outside of the

body. A urethral stricture can occur anywhere in the urethra. A urethral

stricture is a scarred or hardened area that causes narrowing of the caliber of

the urethra. The stricture eventually reduces or obstructs the flow of urine out

of the bladder, making it difficult to urinate. The bladder therefore must work

harder to push the urine through the narrowed area of the urethra.

Symptoms of Urethral Strictures:

Symptoms of urethral stricture can range from no symptoms at all (asymptomatic), to mild discomfort, to complete urinary retention (inability to urinate). Some of the possible symptoms of urethral stricture include the following:

� Reduction in urine flow rate � Prolonged time needed to empty the bladder. � Frequent urination during day and night called nocturia � Sudden urges to urinate (urgency) � Sensation of incomplete emptying � Urine infections can occur.

Causes of Urethral Strictures:

Most urethral strictures arise from an injury to the urethra. Common causes of urethral stricture include:

A common urethral stricture cause is straddle trauma injury to the urethra.

� When the pelvis is fractured, in some cases there is an associated tear of the membranous portion of the posterior urethra. In most cases the ends separate, and the patient is completely unable to urinate.

� Men with Lichen Sclerosus have whitish discoloration of the penile skin and can develop strictures involving the meatus alone, or longer strictures.

� Hypospadias treatment with surgery may become complicated by urethral stricture development. � Other Urologic Procedures may damage urethral opening. � The above represents the most common causes of strictures. Other causes include foreign body insertion into the

urethra and urologic surgeries such as penile implant surgery.

Diagnosis of Urethral Strictures:

Your doctor will ask about your symptoms and your medical history and conduct a physical exam. Your doctor may recommend a number of tests to pinpoint the cause, location and length of the urethral stricture, including:

Preparation for Urethroplasty Surgery:

A thorough pre-operative assessment by your urologist would comprise of

� physical examination, � urinalysis for the presence of blood and white cells, � urine culture for infection and � Cystoscopy to confirm the diagnosis of urethral stricture � The standard urethral imaging procedures like Retrograde Urethrogram (RUG) and Voiding Cystourethrogram

(VCUG) will also be performed.

You will be hospitalized at least one day before the surgery. Inform your surgeon about your other health conditions and medications (including all the prescription, non-prescription medications, nutritional supplements i.e. vitamins, minerals and herbal products). Refrain from taking aspirin or Ibuprofen at least 2 weeks before Urethroplasty. Stop smoking a few weeks before Urethroplasty to prevent healing problems during recovery period. Do not eat or drink anything for at least 10 - 12 hours before the Urethroplasty.

Urethroplasty Surgery Procedure:

It involves surgery to remove the involved segment and re-attach the two normal ends. This is called excision and primary anastomosis. This procedure is best suited for short strictures involving the bulbar or membranous urethra in particular. When this repair is not possible, tissue can be transferred to augment and therefore widen the narrow segment to a normal caliber. For example, the urethra can be augmented using penile skin. Other tissues that can be used to reconstruct the urethra include a graft of buccal mucosa (skin inside the cheek). When the above procedures are not an option, alternatives include a two-stage repair where a buccal mucosa and/or a split-thickness skin graft is placed along the undersurface of the penis, and later rolled into a new urethra (neo-urethra). The choice of repair is individual and influenced by the length and location of the stricture, the availability of local tissue, and other factors. Surgery is performed uder genral anethesia.

Types of Urethroplasty Surgery:

Following are the various types of Urethroplasty surgery procedures available;

� Urethroplasty for Lichen Sclerosis � Penile Urethroplasty � Peno-bulbar Urethroplasty � Bulbar Urethroplasty � Urethroplasties for Hypospadia � Posterior Urethroplasty � Urethroplasty for Epispadia � Penile Curvature � Penile Cancer

� Complete physical examination

� Urethroscopy/Cystoscopy and Calibration

� Urethral X-Ray Imaging

� Bladder scan to check the Post Void Residual

� Other non-invasive test to measure the flow rate is called a Uroflow

� Ultrasound and MRI of the urethra are other imaging tests that can be

utilized

Follow Up Care Post Urethroplasty Surgery:

The follow up after urethroplasty surgery is very important; this is because most urethral strictures recur within the first year or two after surgery.

� After surgery, a urethral catheter is left in for 2-4 weeks depending upon the type of surgery that was performed. When patients return to clinic the bladder is filled with X-ray contrast and the catheter is gently removed.

� While X-rays are being taken, the patient voids and the area of the surgery is evaluated. If the area of surgery shows no leakage, the catheter is left out and patients begin to void normally.

� Most urethral strictures recur within the first year or two after surgery. Patients are seen every 3-6 months in their first year after surgery.

� Patients undergo cystoscopy of the urethra and the urinary flow rate and residual urine is measured. � In addition patients have a scope examination of the surgical area in which a flexible small scope is placed into the

urethra from the penis, very similar to catheterization and the area of the surgery is examined for recurrent strictures. � Follow up schedule is individualized depending upon the findings of these exams.

Recovery After Urethroplasty Surgery:

� Recovery time depends a lot on the type of surgery that was performed. � Typical patients will be in the hospital overnight after surgery. Once they are independent enough to manage the

catheter they leave the hospital. � It is important to limit activities after urethroplasty until adequate healing has occurred. This means no heavy lifting,

strenuous exercise or work for at least 2 weeks. � Generally, it is best if patients do not work while the catheter is in place, however, patients can start doing work that is

not physical after 10-14 days. � The catheter can be worn draining to a smaller bag that straps to the lower leg under a pair of pants. Wearing a

catheter like this is unobtrusive and very manageable.

Recurrence of Strictures:

When strictures come back after surgery they often are thin and web-like. These strictures can cause a lot of obstruction but often can be treated internally by cutting the stricture with a scope procedure. This is dissimilar to the initial stricture that often has too much scarring to respond long-term to an internal cutting procedure. Some strictures are too dense and do not respond to internal cutting and further surgery is indicated.

Benefits of Urethroplasty Surgery:

The success rate reported for Urethroplasty to treat urethral stricture is 70 80%. For people experiencing pain from a very narrow urethra, Urethroplasty procedure can seem like a miracle. It can also help eliminate frequent urinary tract infections. One must always weigh the benefits and risks before having surgery, and make sure to find a doctor that is trustworthy. Urethroplasty can give relief from many problems related to urination like Noctiria, reduction in urine flow rate, urine urgency, etc.

Urethroplasty Surgery in India:

Indian hospitals offer the best urology care team which can move you quickly from diagnosis to recovery, Urologists at Indian hospitals can provide faster recovery with minimal scaring using both minimally invasive and reconstructive surgical techniques to treat urethral strictures and other diseases of the urinary tract. It is a fact that India provides best results in urethroplasty surgery. Most of the hospitals follow international standards of clinical care and provide the best health and medical care services. With latest technology, multi-disciplinary capability, state of the art facilities, world-class medical infrastructure and excellent ambience, urosurgery hospitals in India are poised to become the most advanced and progressive healthcare institution in this part of the world.

Cities in India offering Urethroplasty Surgery at top hospitals are as follows;

Mumbai Hyderabad Kerala

Delhi Pune Goa

Bangalore Nagpur Jaipur

Chennai Gurgaon Chandigarh

Cost of Urethroplasty Surgery in India:

The unparalleled commitment of the urosurgeons and other health professionals has led them achieve better outcomes and improved quality of life for millions of patients who visit India every year for urethra related diseases. Most of the Urosurgeons and urologists in India have been recognized for their contributions to the specialty through national and international awards. That makes India the most sought-after destination for uretheroplasty. The cost of Uretheroplasty if compared with other countries is extremely less. Many patients select India as they find treatment in India to be extremely cheap. Most of the patients end up saving at least 50% of their budget in India.

Cost Comparison of Uretheroplasty Surgery:

India US UK

$3000-$5000 $10,000-$12,500 $15,000-$18,000

Some of the common countries from which patients travel to India for surgery are:

USA UK Canada

Australia New Zealand Nigeria

Kenya Ethiopia Uganda

Tanzania Zambia Congo

Sri Lanka Bangladesh Pakistan

Afghanistan Nepal Uzbekhistan

ABOUT INDIA

Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.

Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city.

Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.

Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.

Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India,

Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra.

Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet.

Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.

Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism.

Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India.

Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery.

Patients Testimonial:

Mr. Uchendu, Nigeria

Urethroplasty Surgery in India

Hello everyone,

I am Uchendu and I came to India for surgery by urethroplasty surgeons in Mumbai India. I first spoke to Doctor through the information given in the tour2india4health and was impressed with the information which was given without pressure. I felt confident with the Consultation information; all my questions were answered, and again didn't feel under pressure. Dialogue continued via email and nothing was left unanswered, I was given names of people to contact who had had the surgery by urethroplasty surgeons in Mumbai India, and they were all positive. So, after few months of talking about it I acted. I am hoping that I can continue to have confidence to enquire in anything else I may need for urethroplasty surgeons in Mumbai India. I will certainly recommend you to people who ask me, I haven't kept it a secret so have no hesitation in giving your contact numbers. I just wanted to say a massive thank you to all at tour2india4health for your fantastic service, support and care from start to (nearly) finish! I was very apprehensive, as some of you may know, but feel so grateful to you for making me feel at ease and always happy! I'm so glad I made the right choice in you and will always recommend tour2india4health and hold you with utmost regard. The urethroplasty surgeons in Mumbai India also use ultramodern medical facilities which were noticeable and fantastic.

Thanks again and wish you all the best.

Thank you Mr.Uchendu Nigeria

Knee Replacement Surgery in India

Knee replacement surgery also known as knee arthroplasty is procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports). Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.

Knee Replacement Surgery Candidates A person would be considered a candidate for knee replacement if there is:

• Daily pain • The pain is severe enough to restrict work, recreation and ordinary activities of daily living • Significant stiffness in the knee • Significant instability (constant giving way) of the knee • Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee

• Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis

Success Rate of Knee Replacement Surgery: Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.

Knee Replacement Surgery Preparations:

• If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery. • If you drink, don't have any alcohol for at least 48 hours before surgery. • Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to

strengthen your upper body will help you cope with crutches or a walker after surgery. • Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery.

This examination will assess your health and your risk for anesthesia. The results of this examination should be forwarded to your orthopaedic surgeon, along with a surgical clearance.

• Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and answer any last-minute questions.

• You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray. • Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to

stop taking certain medications or your surgeon may recommend substitute medications until your surgery. Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.