Exploring surgery for UTIs

Urinary tract infections (UTIs) are common bacterial infections that affect the urinary system, including the kidneys, bladder, ureters, and urethra. While most UTIs can be effectively treated with antibiotics, in some cases, surgery may be necessary to address underlying structural issues or complications.

In this article, leading consultant urological surgeon Mr Andrew Symes explores the topic of surgery for UTIs and answer some key questions that patients may have.

What are the common surgical procedures for UTIs?

Urethral dilation

Purpose: Urethral dilation is a procedure used to widen a narrowed or scarred urethra, which can occur due to recurrent UTIs or other conditions such as urethral stricture.

Procedure: During the procedure, a urologist inserts a series of gradually larger dilators into the urethra to stretch and widen it. This can help improve urine flow and reduce the risk of recurrent infections.

Cystoscopy

Purpose: Cystoscopy is a minimally invasive procedure used to visualise the inside of the bladder and urethra to identify any abnormalities or sources of infection.

Procedure: A thin, flexible tube with a camera (cystoscope) is inserted into the urethra and advanced into the bladder. The urologist can then examine the bladder lining and urethra for signs of infection, inflammation, or structural abnormalities.

Lithotripsy

Purpose: Lithotripsy is a procedure used to break up kidney stones (renal calculi) into smaller fragments that can be passed more easily through the urinary tract.

Procedure: Extracorporeal shock wave lithotripsy (ESWL) is the most common type of lithotripsy. It involves using shock waves generated outside the body to fragment kidney stones. The fragmented stones can then be passed out of the body through urine.

Surgical correction of anatomical abnormalities

Purpose: In some cases, structural abnormalities of the urinary tract, such as ureteral strictures or vesicoureteral reflux (backflow of urine from the bladder to the kidneys), may predispose individuals to recurrent UTIs.

Procedure: Surgical correction of these abnormalities may be necessary to prevent recurrent infections and preserve urinary function. This may involve procedures such as ureteral reimplantation or bladder reconstruction.

Who might benefit from surgery for UTIs?

Surgery for UTIs may be recommended for individuals who experience:

• Recurrent UTIs that do not respond to conservative treatment measures, such as antibiotics and lifestyle modifications.
• Structural abnormalities of the urinary tract, such as urethral strictures, bladder diverticula, or kidney stones, that contribute to recurrent infections or urinary symptoms.
• Complications of UTIs, such as abscesses, fistulas, or urinary obstruction, that require surgical intervention to resolve.

What are the risks and benefits of surgery for UTIs?

Risks

As with any surgical procedure, surgery for UTIs carries certain risks, including infection, bleeding, injury to surrounding organs or tissues, and adverse reactions to anaesthesia.

Additionally, there is a risk of recurrence of UTIs or development of new urinary symptoms following surgery, particularly if underlying risk factors are not adequately addressed.

Benefits

Surgery for UTIs can help alleviate symptoms, prevent complications, and improve overall urinary function and quality of life for affected individuals.

By addressing underlying structural abnormalities or contributing factors, surgery may reduce the frequency and severity of UTIs and decrease the need for long-term antibiotic therapy.

Considering every aspect before going ahead

While most UTIs can be effectively managed with antibiotics and conservative measures, surgery may be necessary in certain cases to address underlying anatomical issues or complications. Surgical interventions aim to alleviate symptoms, prevent recurrence, and improve urinary function and quality of life for individuals affected by recurrent or complex UTIs. As with any medical decision, it is important for patients to discuss the risks, benefits, and alternatives of surgery with their healthcare provider to make informed choices about their treatment options.

Considering surgery for recurring UTIs? Arrange a consultation with Mr Symes via his Top Doctors profile.