Orandi’s Urethroplasty for Distal Penile Urethral Stricture at Institute of Urology, Jaipur: A 31-year-old male, was admitted to our hospital – Institute of Urology, Jaipur under the care of Dr. M. Roychowdhury and Dr. Rajan Bansal for definitive management of a distal penile urethral stricture.
Presenting Complaints and History
The patient was a known case of distal penile urethral stricture. He had previously undergone cystoscopy using a ureteroscope at our hospital, which confirmed a distal penile urethral stricture while the proximal urethra appeared normal. He was subsequently admitted for definitive surgical management.
The patient also had a past history of undergoing optical internal urethrotomy (OIU) at another center for penile urethral stricture. However, he developed recurrence of symptoms, which necessitated further evaluation and surgical reconstruction. There was no history of any significant medical illness, and the patient reported no known drug allergies.
Investigations
Routine laboratory investigations showed serum creatinine of 0.89 mg/dL, indicating normal renal function. Retrograde urethrography (RGU) demonstrated a distal penile urethral stricture. Preoperative evaluation including electrocardiography was within normal limits, and chest X-ray showed no abnormality.
Surgical Procedure
After detailed counselling regarding the disease, treatment options, and expected outcomes, the patient was planned for surgical reconstruction.
Then, the patient underwent cystoscopy followed by Orandi’s urethroplasty under spinal anesthesia.
A ventral penile skin incision was made, and the strictured segment of the urethra was identified and laid open. Intraoperative cystoscopy was performed to evaluate the proximal urethra, which was found to be normal.
Orandi’s urethroplasty was then performed. A penile skin island flap was carefully fashioned and rotated to reconstruct the opened urethral segment. The flap was utilized as a ventral onlay flap to augment the urethral lumen and restore adequate urethral caliber. A 16 Fr Foley’s catheter was inserted to ensure urinary drainage and facilitate healing of the reconstructed urethra.
Postoperative Course
The patient tolerated the procedure well. The postoperative period remained uneventful, and he recovered satisfactorily during his hospital stay.
The patient and his relatives had been counselled thoroughly before surgery regarding the procedure and its expected outcome. Following surgery, he remained hemodynamically stable with no postoperative complications.
Best Hospital of Urethral Stricture – Institute of Urology, Jaipur
The Institute of Urology, Jaipur is recognized for its advanced expertise in the management of all types of urethral stricture diseases, ranging from simple short-segment strictures to complex and recurrent urethral pathologies. Under the leadership of experienced urologists such as Dr. M. Roychowdhury and Dr. Rajan Bansal, the institute routinely performs a wide spectrum of reconstructive urethral surgeries including urethral dilatation, optical internal urethrotomy, buccal mucosal graft urethroplasty, and various flap-based urethroplasties such as Orandi’s technique. With a strong focus on reconstructive urology, meticulous surgical technique, and patient-centered care, the institute achieves excellent functional outcomes in the treatment of urethral strictures while minimizing recurrence and complications.
