1st stage urethroplasty with buccal mucosal graft (BMG) : University College London Hospitals NHS Foundation Trust

What to expect following surgery

This surgery has been carried out to replace a section of unhealthy urethra (water pipe) by using tissue from the inside of the cheek (buccal mucosal graft, BMG).

Immediately after surgery you will have a dressing around the penis which will keep your urethral graft wound clean and dry. It is normal to be discharged home with this dressing in place.

You will also be sent home with a urinary catheter in place to keep the graft dry and promote healing. It is usual for the urinary catheter to remain in place for up to two weeks to allow the graft to heal.

You will be shown how to look after this and provided with any necessary supplies When you go home it is important to keep the dressing dry so you must not bath or shower.

You will receive a date to attend clinic 6-10 days after surgery for the dressing to be removed by the Clinical Nurse Practitioner (CNP) or surgeon. Sometimes the graft site requires another dressing, but you will be advised if this is necessary.

The graft is taken from the cheek (buccal mucosa) inside your mouth. You will be able to eat and drink on return to the ward once the gauze padding has been removed but we would recommend avoiding very hot or very cold foods and fluids as this may cause additional discomfort.

What to expect when you get home

Bleeding: You should not experience any major bleeding. It is however normal for there to be slight ooze of blood through the dressing. If it persists then apply pressure to the area using a clean piece of gauze over the area and press firmly for about 10 mins. If bleeding does not stop, seek medical advice.

Pain: You are likely to experience some discomfort or pain following your operation particularly inside the mouth where the graft was taken from. Please take your painkillers/ mouthwash regularly as prescribed. Do not exceed the stated dose. This discomfort/ pain will improve over time but may take a few weeks to disappear.

As the inside of the mouth begins to heal it can feel quite tight. This is normal and nothing to worry about.

Returning to work: You will usually require two weeks off work. If you require a sick certificate, please ask the medical team before you leave hospital.

Follow up appointment: An outpatient appointment is required one week after surgery to see the Clinical Nurse Practitioner (CNP) for removal of the operative dressing. You will be reviewed thereafter at 6-8 weeks after the surgery by the surgeon. The graft needs to heal or ‘take’ and mature for six months before the 2nd stage of the surgery which is to roll up the urethra into a tube.

Aftercare: To minimise complications you must not do any heavy lifting (nothing heavier than a full kettle of water) for two weeks.

You must not have sex for six weeks following surgery or until the graft has fully healed.

If you experience any of the following, please contact the Clinical Nurse Practitioner or your medical team via the numbers below. Out of hours, please contact your GP or nearest Accident & Emergency Department.