Academic and clinical excellence in a private practice setting

Jerry G. Blaivas, MD, FACS

Dr. Blaivas is a world-renowned urological expert, surgeon, distinguished author, educator, and medical pioneer. He was one of the founders of urodynamics and established many of the current surgical procedures used to correct stress incontinence, urinary fistulas, urethral diverticulum, overactive bladder and neurogenic bladder.

He is also one of the few surgeons who routinely performs reconstructive surgery for prolapse and incontinence without the use of mesh. His success in this area has led him to publishing one of the largest series in the world on treatment of mesh complications.

Dr. Blaivas possesses decades of experience providing urology care to some of the most complex cases ever encountered, bringing academic and research-based modernization to the clinical forefront. His research in developing new medical techniques has become the standard in patient care, including breakthrough treatments and research in:

Mesh complications
Radiation complications
Autologous Slings
Natural Tissue Repairs

Dr. Blaivas was recently honored by the Canadian Journal of Urology as one of their Legends of Urology. Read the article >

Schedule an appointment online or call Dr. Blaivas today at (646) 205-3039 to schedule a confidential consultation.

Insurance Information

Dr. Blaivas does not participate with private insurance plans. He is considered an “Out of Network” physician, which means that payment in full is expected at the time of the visit and you will be reimbursed directly according to your insurance plan. As a courtesy, we offer to complete and mail claims on your behalf and assist you in obtaining timely reimbursement.

About the Uro Center of New York

At the Uro Center of New York, we combine clinical and academic excellence in a private practice setting. For over twenty years, our staff has been committed to diagnosing and treating people with bladder and prostate conditions. Our services include the use of state-of-the-art video urodynamic equipment and a custom-designed computer system that assists our physicians in ensuring an accurate and prompt diagnosis.

Learn more >

See Our Main Site www.UroCenterofNewYork.com
Blog Posts are Below:

Category Archives: Urethral Strictures

Urethral Strictures in Women

Urethral strictures in women are rare, and they account for only about 15% of women with BOO. Urethral obstruction in women is functional or anatomical.

When the obstruction is anatomical, it can be secondary to compression or scar. Compressive obstruction can result from prolapse, urethral diverticulum or tumor. Strictures may be iatrogenic, idiopathic or traumatic, or as a result of deterioration.

Because urethral strictures are so uncommon and high quality studies are few and far between, the management of urethral strictures in women is largely experimental. Treatment options typically include urethral dilation, self-catheterization, urethrotomy and urethroplasty.

Although data is limited, it appears that urethral dilation is of benefit only in the short term, which is measured in months, not years. In our study, only 1 of 17 patients had a continual response to urethral dilation alone. This suggests that definitive surgical treatment should be considered when conservative measures fail or when stricture is associated with partial or complete loss of the urethral wall.

Urethral Strictures in Women: Techniques

A variety of surgical techniques have been described for urethral strictures in women, including VFU, dorsal urethroplasty with labia minora, lingual graft, skin graft or pedicle flap, vestibular flap urethroplasty and buccal mucosal graft urethroplasty. Each procedure utilizes a variation on two basic urethroplasty approaches – the vaginal flap and vaginal wall grafts.

Vaginal flap neourethral restoration for urethrovaginal fistula was first described in 1935. After urethral catheterization has been completed, a U-shaped flap is created on the anterior vaginal wall. The stricture is incised and the flap is advanced, which avoids grafting or tunneling the tissue and has few problems.

Buccal mucosal graft urethroplasty has been successfully applied to both male and female urethral stricture disease. Advantages include hairless tissue that is accustomed to a damp environment and has elasticity. It is an option when there is inadequate vaginal tissue for grafting.

What is Urocenter of New York’s Experience Treating Urethral Strictures in Women?

For treatments of urethral strictures at URO Center of New York, the urethra is incised dorsally until healthy proximal urethra is identified. We use the resistance experienced during the withdrawal to assess the residual stricture. Subsequently, the graft is sutured into the urethra and covered with periurethral tissue.

Bottom Line: Urethral stricture is uncommon in women and literature on the topic is sparse. In our experience with 17 consecutive women with urethral stricture seen in a 12-year period, urethral dilation was rarely effective.

Urethroplasty had a 100% success rate at 1 year in 9 women but strictures recurred at 6 years in 2 who underwent ventral vaginal flap urethroplasty, requiring repeat urethroplasty with a buccal mucosal graft. Women with urethral strictures should be monitored for a longer term due to the small risk of recurrence.

Dr. Jerry Blaivas is the World Leading Expert on Complicated Urological Problems

For more information regarding urethral strictures in women, visit our website or call us at 646-205-3039 for an appointment.

Uro Center of New York
Jerry G. Blaivas, MD, FACS
445 East 77th Street
New York, NY 10075
646-205-3039

What is a Urethral Stricture and what happens if I have one?

Do you have or want to know what is a urethral stricture? A Urethral stricture is a narrowing of the urethra, often caused by scarring. The urethra is the tube that carries urine from the bladder out of your body. A urethral structure restricts the flow of urine out of the body and can cause inflammation or infection in the urinary tract.

Men are more likely to experience urethral stricture than women are, as men have longer urethras. Urethral strictures are not common in women and infants.

What causes urethral stricture?

urethral-stricture-medical-infographic-information-02 Urethral stricture is caused by the development of scar tissue or tissue inflammation that narrows the urethra. It can happen at any point in the urethra, from the bladder to the tip of the penis. Medical procedures that involve inserting an instrument like an endoscope into the urethra or use of a catheter or tube to drain urine from the bladder can create scar tissue. Injury to the urethra or pelvis, such as from bike riding or getting hit near the scrotum, can also create scar tissue. Scar tissue also may form from other medical conditions like an enlarged prostate, prostate gland removal surgery, urethral cancer, prostate cancer, or sexually transmitted infections.

To prevent urethral stricture, it is important to avoid injury to the urethra and pelvis and to be careful with self-catheterization and avoid sexually transmitted infections. If a sexually transmitted infection like Gonorrhea or Chlamydia is contracted, take antibiotics early to treat the infection and prevent urethral stricture. Although urethral strictures are not contagious, sexually transmitted infections are. Treating a sexually transmitted infection can help you prevent urethral stricture, and also can help prevent them in future sexual partners.

Urethral stricture signs and symptoms

Several urinary problems may indicate urethral stricture. A low or spraying urine stream, incomplete bladder emptying, and difficulty or pain when urinating are common signs. Bloody or dark urine or blood in semen may also indicate urinary stricture. Many with urinary stricture experience more frequent urination or a more frequent urge to urinate. Men with urethral strictures also may experience urinary tract infections.

What happens if I have a urethral stricture

It is important to seek treatment for a urethral stricture. Without appropriate treatment, urinary problems may continue. If a urethral blockage lasts a long time, it can damage the kidneys and lead to an enlarged bladder.

Appropriate treatments for urethral strictures depend on the size of the urethral blockage and the amount of scar tissue present. A urologist can help you determine the best treatment route for you. Treatment options include dilation of the structure with gradual stretching with an instrument called a dilator, urethrotomy (cutting the stricture through a scope), or open surgery to remove the stricture.

Contact us today to schedule an appointment with the best urethral stricture urologist in NYC.

For more information, visit our website: www.UrocenterofNewYork.com

What Are Urethral Strictures and How Are They Treated?

Urethral strictures are an uncomfortable problem for people who have had trauma or surgery on the urethral tract. Where areas of scar tissue have formed on the urethra, there can be some constriction when someone is trying to urinate. This can be extremely unpleasant and can even cause serious problems such as bladder infections. If you have a urethral stricture as a result of surgery or an injury or other trauma, then you will need to have this treated. Here, we are going to look at what your options are.

Diagnosis of Urethral Strictures

You will need to have your urethral stricture diagnosed by a urologist so that you can have a course of treatment prescribed for you that will resolve the issue. It is best to book an appointment with a urologist as soon as you notice the symptoms associated with urethral strictures after having surgery on this area or after an injury, such as difficulty peeing or a burning sensation when you pee. In some cases, it may just be inflammation following the trauma, however, if a stricture is present then you will need to have further surgery to address it.

How Are Strictures Treated?

There are different ways of treating urethral strictures, which depend on the severity and location of the stricture itself. In some cases, you may need to have some tissue grafted into the urethra or you may have to have some scar tissue removed from the urethra, and this can be done via surgery under general anesthetic. Strictures do not usually go away by themselves and so you will need some kind of intervention to make sure that the symptoms that you are experiencing as a result of having strictures in your urethra go away and you are able to experience normal urinary and erectile function.

In order to establish what kind of treatment is best for your specific case, you will need to speak to a professional urologist.

If you have a urethral stricture or are concerned that you may be experiencing the symptoms associated with it, then the best thing to do is make an appointment with a urologist right away. Get in touch with us and you can make an appointment with the best urologist in NYC and put your mind at ease that your urethral stricture will be treated quickly and professionally.

Call us today at 646.205.3039 to schedule an appointment to meet with the best NYC urologist.

Tests to Diagnose and Evaluate of Urethral Strictures: Part 2

An additional test that we find to be very useful to evaluate a stricture is the cystoscopy. This cystoscopy is done in the office and is typically done one the same day as the retrograde urethrogram. After local anesthesia (usually lidocaine jelly) has been placed into the urethra a cystoscope is gently placed into the urethra. The cystoscopy allow direct visualization of the urethra as well as any other anatomic anomalies that may be present in the urethra. In addition, the cystoscopy may also reveal urethral lesions that are not well visualized on a retrograde urethrogram. The downside of the cystoscopy is that often a cystoscope will be too wide to permit passage through the narrow opening of the urethral stricture and, consequently, it can be difficult to estimate the length of the urethral stricture as well as the presence of additional strictures behind the impassable one. For this reason, we feel that a cystoscopy generally should be done in conjunction with the retrograde urethrogram to diagnose and evaluate urethral strictures.

The cystoscopy is useful to evaluate urethral strictures in other ways also. Dr. Purohit and Blaivas have developed and published a staging system for urethral strictures that relies on the use of cystoscopy. It is currently the only validated staging system available for describing urethral strictures. Typically, urethral strictures have been studied using a binary scale (or 2 part) in the medical literature – that is patients are reported as either having a stricture or not. We have found that the simple binary classification of strictures and analysis that are based on the simple binary staging system of strictures is often inadequate to fully describe the range of urethral strictures that patients can develop. Some strictures are very slight narrowing in the urethra that causes no symptoms and may never become a problem for patients. Other urethral strictures, however, are very tight and cause terrible suffering for patients. Our staging system is the first step to better incorporate the large variety of strictures. In our opinion not all strictures should be treated the same – in fact some strictures may not need any surgery at all!

Dr. Purohit and Dr. Blaivas’ approach incorporates the staging system and allows a more nuanced and individualized surgery. The Purohit-Blaivas urethral stricture staging system uses a 4-point system to describe the range of strictures that patients can have; it is based on cystoscopic findings alone. By having a four tiered system, we are able to better describe and study the range of strictures that the patients present with.

The staging system is as shown below.

We will discuss some of the research that has utilized our staging system in a future blog post.

male-urological-services-doctor-nyc Urologic Problems in Men

female-urological-services-doctor-nyc Urologic Problems in Women