Private Urethroplasty

Surgery usually about 2–4 hours, depending on how long the stricture is, where it is in the urethra, whether you need a graft. Expect to be in clinic most of the day for check‑in, anaesthesia, surgery, and early recovery.

Basic steps (what actually happens)

1. Check‑in and planning

• You meet the nurse, anaesthesia team, and surgeon.
• They review your history, imaging, and previous tests.
• The plan is confirmed: where the stricture is, what type of urethroplasty they expect to do, and what graft (if any) might be needed.

2. Anaesthesia

• You almost always get general anaesthesia, so you’re fully asleep.
• Sometimes a spinal/epidural is added for extra pain control.

3. Position and prep

• You’re positioned on a padded table so the surgeon can reach the urethra and, if needed, your mouth (for a cheek graft).
• The skin is cleaned with antiseptic and covered with sterile drapes.

4. Accessing the urethra

• A careful incision is made in the perineum (the area between the scrotum and anus) or along the penis, depending on where the stricture is.
• The surgeon gently exposes the urethra while protecting nearby nerves and blood vessels.

5. Finding and opening the stricture

• The urethra is opened to directly see the scarred, narrowed segment.
• The tight area is either:
  • Cut out and the healthy ends are re‑joined (excision and primary anastomosis), or
  • Opened up and then patched or rebuilt using a graft.

6. Graft (if needed)

• For longer or more complex strictures, the surgeon may:
  • Take a thin graft from the inside of your cheek (buccal mucosa), or
  • Use another suitable tissue.
• This graft is sewn onto the urethra to widen and rebuild the tube.

7. Rebuilding the urethra and placing a catheter

• The urethra is carefully closed and reshaped around a catheter so the new passage is the right size and shape.
• A urinary catheter (and sometimes a second suprapubic catheter through the lower abdomen) is left in place to let the repair heal.

8. Closing and dressing

• Deeper layers and skin are closed with stitches.
• Dressings are applied, and the catheter is secured.

9. Wake‑up and early recovery

• You wake up in a recovery area.
• The team checks your breathing, pain, and catheter position.
• You get early instructions about moving carefully, catheter care, and what to expect over the next few days.

Urethroplasty is a bigger surgery than a simple scope or dilation, so expect recovery to be a bit of a process. Everyone heals differently, follow your surgeon’s plan.

First few days (Days 1–3)

What it feels like

• Sore and bruised between the legs (perineum), sometimes inside the mouth if you had a cheek graft
• You’ll have a catheter draining urine

Main goals

• Control pain and swelling
• Protect the incision and catheter

Typical activities

• Short, careful walks around the house
• Rest with hips relaxed; avoid big stretches or sudden movements
• Keep the incision clean and dry as instructed

Days 4–14

What it feels like

• Soreness is still there but slowly settling
• Sitting on hard chairs can feel uncomfortable or “pressure‑y”

Main goals

• Move comfortably without pulling on the repair
• Take care of the catheter and mouth (if graft used)

Typical activities

• Light daily tasks and desk/school work from home if you feel up to it
• Gentle walking, but no running, heavy lifting, or sports
• Quick showers usually OK once your surgeon says so (no baths or hot tubs)
• Regular catheter care and drinking enough fluids

Weeks 3–6

What it feels like

• Discomfort continues to improve
• You’ll likely have a catheter check or imaging (like a urethrogram) to see how the repair is healing

Main goals

• Make sure the new urethra is healing well
• Gradually get back to more normal routines

Typical activities

• If your test shows things look good, the catheter may be removed
• Back to most normal walking and light activities
• Many people can return to non‑physical school or desk work if they haven’t already

Weeks 6–12 and beyond

What it feels like

• Urinating should feel easier and more “normal” than before surgery
• Energy levels and comfort keep improving

Main goals

• Build back full confidence with urinating and movement
• Slowly return to sport, heavier work, or the gym (when cleared)

Typical activities

• Gradual return to:
  • Running or more intense cardio
  • Gym and job duties that involve lifting or being on your feet
• Follow‑up visits to check that the urethra is staying open and you’re happy with the result

Red flags – call your team right away

Anytime after surgery, contact your surgeon or go for urgent care if you have:

• Fever, chills, or feeling very unwell
• Worsening redness, swelling, or pus‑like drainage from the incision
• Catheter not draining, sudden trouble urinating, or severe bladder pain
• Big increase in pain, especially in the perineum or groin
• New calf pain/swelling or chest pain/shortness of breath

Recovery from urethroplasty is about being patient: protect the repair, respect the catheter, and follow your surgeon’s timeline, even if you feel better sooner.

For private care in Canada, urethroplasty is a major reconstruction, so it’s on the higher side. And the cost varies substantially based on the procedure type (excision and primary anastomosis, graft/flap, staged), location, surgeon expertise, anesthesia.

In Canada, private centres charge roughly $15,000–CA$30,000+

• The exact number depends on:
  • How complex/long the stricture is
  • Whether you need a cheek graft
  • OR time and facility type (clinic vs hospital partnership)

How much does it cost in the United States on average?

In the U.S., you can expect between CA$15,500 - $30,000+

What’s usually included

Most bundled quotes typically cover:

• Surgeon fee (and assistant, if used)
• Anaesthesia and monitoring (usually general anaesthesia)
• Accredited facility/OR fees, nursing, and standard supplies
• Use of surgical equipment (e.g., loupes/magnification, instruments, catheter placement)
• Immediate post‑op recovery care
• At least one routine follow‑up visit to check healing and review early results

What’s often not included

These may be billed separately or handled outside the package:

• Initial consults and pre‑op tests (cystoscopy, uroflow, imaging, lab work)
• Extra OR time beyond the booked block or an unplanned overnight stay
• Prescriptions after surgery (pain meds, antibiotics, stool softeners)
• Later imaging or flow tests beyond the standard follow‑up protocol
• Travel and accommodation if you’re coming from another province or country

Tips to compare quotes

• Ask for line items: surgeon fee, facility, anaesthesia, and any special equipment.
• Confirm:
  • What happens if the surgery is more complex than expected
  • How many follow‑ups are included
  • Whether catheter removal and post‑op tests are part of the package.

Choosing your surgeon is one of the benefits of going the private route. Here's how to choose wisely.

What to look for

Experience and volume

• Ask how many urethroplasties they do per year.
• Ask if they routinely handle:
  • Longer strictures
  • Redo surgeries
  • Graft (buccal mucosa) cases
• Higher volume usually means more refined technique and smoother pathways.

Credentials and training

• Confirm they’re licensed with your provincial college (CPSO, CPSBC, CPSA, CMQ, etc.).
• Look for an FRCSC‑certified urologist with specific training or focus in:
  • Reconstructive urology
  • Urethral surgery / trauma

Technique and tools

• Ask which techniques they use (EPA, graft/patch, staged repairs) and which they recommend for you.
• Ask how they decide when to use a cheek graft and how they harvest it.
• Check that they use proper imaging and scopes before surgery to plan the repair.

Outcomes and safety

• Ask for recent stats, like:
  • Stricture recurrence rates
  • Infection or complication rates
  • How often patients need another procedure
• A good surgeon should be comfortable talking about numbers and trade‑offs.

Pre‑op and after‑care

• You want a clear plan for:
  • Pre‑op tests (cystoscopy, uroflow, imaging, bloodwork)
  • How long the catheter will stay in
  • When you’ll have imaging/flow tests after surgery
  • How to reach the team if you’re worried

Facility quality

• Prefer an accredited hospital or surgical centre (Accreditation Canada, CAAASF, or provincial equivalent).
• Ask about:
  • Consistent anaesthesia coverage
  • Access to imaging and emergency backup if something unexpected happens

Pricing transparency (for private care)

• Ask for an itemized quote:
  • Surgeon fee
  • Facility fee
  • Anaesthesia
  • Graft/extra supplies
  • Follow‑ups and any imaging/cystoscopy included

Questions to ask in your urethroplasty consult

About the surgeon and plan

• How many urethroplasties do you perform each year, and what types (EPA, graft, staged)?
• What does my imaging show exactly, and which technique do you recommend for me and why?
• What is your approximate recurrence rate over the last few years?

Anaesthesia and logistics

• What kind of anaesthesia will I have, and what’s the pain‑control plan afterwards?
• Will I stay overnight, or is it same‑day discharge?

Recovery and follow‑up

• How long will the catheter stay in, and how is it removed?
• When can I return to school/desk work, more physical jobs, and sport/gym?
• What red flags should make me call you or go to the ER?

Costs and documentation (if private)

• What exactly is included in my quote, and what could add extra cost?
• If you have to change the plan mid‑surgery, how is that handled for consent and pricing?
• Will I get a written report and after‑care plan to share with my family doctor?

A strong urethroplasty program is open about results, clear about the plan, easy to reach with questions, and totally transparent about what you’re paying for.