Core Surgical Subspecialty · Prof. Dr. Ali AYYILDIZ
Reconstructive urethral surgery is one of Prof. Dr. Ali AYYILDIZ's premier clinical subspecialties. With decades of experience managing complex urethral strictures, recurrent failed repairs, and fistula revisions, our practice emphasizes definitive surgical restoration of healthy urinary flow.
Recognizing Urethral Stricture Symptoms
A urethral stricture is a scar-tissue narrowing of the urinary channel caused by trauma, prior catheterization, endoscopic surgeries, infections (urethritis), or congenital causes. Classic symptoms include a weakened or split urine stream, straining, post-void dribbling, recurrent UTIs, and incomplete bladder emptying.
Precision Mapping Before Treatment
Successful urethral surgery depends on accurately defining the exact location (meatal, penile, bulbar, or posterior), length, and fibrosis depth of the stricture using uroflowmetry, retrograde urethrography (RUG), voiding cystourethrography, and flexible cystourethroscopy.
Surgical & Endoscopic Options
- Endoscopic Internal Urethrotomy (Cold Knife / Laser): Selected short, primary strictures treated minimally invasively
- Excision and Primary Anastomosis (EPA): Removal of short bulbar scar segments with tension-free microsurgical reconnection
- Buccal Mucosa Graft Urethroplasty: Durable augmentation of long or recurrent strictures using the patient's own oral mucosal tissue
- Fistula, Diverticulum & Hypospadias Revision Surgery: Single-stage or staged reconstruction for previously operated cases
Why Choose Definitive Urethroplasty Over Repeated Dilations?
International guidelines clearly advise against endless cycles of urethral dilation or repeat urethrotomy, which deepen scar tissue over time. Definitive urethroplasty delivers superior long-term patency and liberates patients from chronic catheterization.
Frequently asked questions
When is urethroplasty recommended instead of repeated endoscopic cuts?
When urethral stricture recurs after an initial internal urethrotomy or dilatation, open reconstructive urethroplasty offers the highest long-term cure rate and avoids progressive scarring.
How does buccal mucosa graft urethroplasty work?
A thin strip of healthy inner cheek (buccal) mucosa is used to widen the narrowed urethral segment permanently, providing durable urinary flow even in complex or long strictures.