Spike in Urethral Reconstruction Surgeries at AINU: Road Accidents and Infections Major Contributors

Hyderabad: AINU, India's premier network for Urology and Nephrology care, recently hosted Urethra @AINU, one of the country's largest urology conferences. The event attracted 800 attendees from eight different countries, providing a platform for sharing invaluable insights on the latest techniques in urethral reconstruction surgery. This surgery addresses urethral strictures, a condition characterized by the narrowing of the urethra, which leads to reduced urine flow and various complications. While urethral strictures predominantly affect males, they can also occur in females and children.

In the past, hygiene played a significant role in urethral narrowing, especially in rural areas. However, due to increased awareness and improved policies, the incidence has reduced by 30-40% over the past two decades. Urologists at AINU have observed a rising trend in road accident-led reconstruction surgeries, followed by infection-led. The high number of fatalities has positioned India among the countries with the highest road accident deaths globally.

Speaking about the key factors leading to Urethra Reconstruction surgeries, Dr. Bhavatej Enganti, Consultant Urologist at AINU and organizing secretary of the conference, explained, "Urethral damage often occurs when there are multiple fractures in road accidents. In such cases, it is necessary to wait for a few months before corrective surgery. The incidence of accidents has been increasing recently, and when vehicles collide at high speeds, the urethra, along with other organs, suffers severe damage. We are also observing narrowing of urethra due to UTI and STI-related complications. Radiation treatments for cancer also lead to urethral problems. Congenital abnormalities necessitate such procedures like some children are born without a proper urethra. Additionally, Infections due to extended hospital stays, bedridden conditions, and the use of catheters, can also lead to urethral strictures”.

Urethral repairs have a risk of failure, necessitating the use of the patient's own tissues for operations. Tissue from the buccal cavity(inner lining of the cheeks) is often used. Genetic engineering or bioengineering skills are required for these procedures. When multiple attempts fail, tissue availability becomes an issue, so there are regenerative methods based on cell therapy, where tissue is injected to allow the urethra to heal itself.

Dr. C. Mallikarjuna, Managing Director and Chief Consultant Urologist of AINU said “In the past nine years, we have performed over 1,000 urethral reconstruction surgeries. Starting with 50 cases annually, we now handle 200-250 cases per year, placing us among the top centers in South India for such surgeries. The key aim of the conference is to receive training and learn from experts. Urethral reconstruction surgeries are complex with high failure rates, and there is a pressing need for skilled and efficient surgeons to bridge the demand gap from a patient’s perspective.

Over 800 delegates from eight countries such as UK, Uganda, Nepal, Bangladesh, Singapore, Thailand, and Gulf countries, attended the event. Key stalwart Urologists such as Dr. Sanjay Kulkarni from Pune and Dr. Ganesh Gopalakrishnan from Coimbatore were key faculties at the event. Mr Ajit Rangnekar Former Dean, ISB Hyderabad graced the conference as one of the keynote speakers.