TIL Desk Lucknow:
In a remarkable medical breakthrough, doctors at Max Super Speciality Hospital, Lucknow successfully treated a rare and complex case of complete urethral stricture (narrowing or blockage of the urinary tube due to scarring) in a 52-year-old woman, suffering from severe urinary obstruction and pain for 22 years, after her first pregnancy.
The patient, Mrs. Sangeeta Singh, presented to Max Hospital, Lucknow, with complaints of painful urination and urinary retention. Post initial evaluation, it was identified that she has been dealing with severe urinary obstruction for more than two decades (22 years) since her first pregnancy, requiring over 30 minutes to pass urine. Despite seeking treatment at several hospitals in the past, there was no relief in her condition. Surgery suggested elsewhere was repeatedly ruled out due to high chances of urinary incontinence (meaning inability to control the urine in the bladder leading to involuntary leakage of urine all the time) and complex reconstruction involved requiring special expertise.
Explaining in detail about the case, Dr. Rahul Yadav, Director – Urology, Andrology, Kidney Transplant & Robotic Uro-Oncology, Max Super Speciality Hospital, Lucknow, said, “Mrs. Singh was diagnosed with complete urethral (passage connecting urinary bladder to outside) blockage after her first delivery causing her severe urinary issues. Looking at the complexity of the case, we decided to go ahead with multi-layered technique of advanced reconstructive surgery- Ventral Buccal Graft Urethroplasty with Martius Interposition Flap. In this procedure, a graft is harvested from the inner cheek and used to reconstruct the narrowed or scarred urethra, and placing of a vascularized fat pad from the labia to support the graft site which ensured proper healing.”
Dr Yadav further said, “Female Urethral Stricture to the extent of complete obliteration of the entire urethra, as this case is very rare and serious. With an estimated incidence of 0.1% to 1% among women presenting with difficulties in urination or emptying of the bladder at one go. This condition often gets misdiagnosed as a urinary tract infection or an overactive bladder. Common symptoms include difficulty urinating, slow stream, pain, frequent infections, and, in severe cases, kidney damage. Contributing factors for such cases include childbirth-related trauma, injuries due to any failed surgery, pelvic infections, and sometimes post-menopausal changes that affect urinary health. Mrs. Singh’s surgery was completed in two hours without any complications.”
The patient was discharged a week post-surgery with precautions advised to lead a healthy life post-surgery. The patient is doing well now and can pass urine painlessly. Max Hospital is one of the few centres in India offering advanced female urethral reconstruction, backed by state-of-the-art infrastructure, skilled surgical teams, and post-operative rehabilitation.
