Posterior urethral reconstruction is a surgery for males. It repairs narrowing in your urethra after trauma or treatment for prostate cancer. A urologist removes the damaged section of your urethra and reattaches the two healthy ends. Most people make a full recovery after about eight weeks.
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Posterior urethral reconstruction is a surgical procedure for males that you sometimes need after trauma to your urethra or after prostate cancer treatment.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Your urethra is the tube that carries urine (pee) and semen through your penis and out of your body. The posterior urethra is a one- to two-inch section of your urethra. It extends from the narrow outlet at the bottom of your urinary bladder (bladder neck) through your prostate gland and external urethral sphincter muscle in your pelvic floor. Posterior urethral reconstruction fixes this section of your urethra.
Healthcare providers usually perform posterior urethral reconstruction to treat a urethral stricture. A urethral stricture is when your urethra narrows. Depending on the severity of the narrowing, your pee stream may get weak or slow down, or it may stop entirely.
A urethral stricture may occur after trauma, like a straddle injury or pelvic fracture. Common pelvic fracture causes include:
Urethral strictures may also occur after urinary tract surgery or prostate cancer treatment, including:
Before a healthcare provider considers posterior urethral reconstruction, they’ll order tests to evaluate your posterior urethral stricture. These tests may include:
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If trauma causes a urethral stricture, they’ll also make sure your injury won’t get worse (is stable). During this time, they’ll often drain your pee with a suprapubic catheter.
Before surgery, you’ll generally need to talk to your surgeon and take some steps to keep you safe. This may include:
If you must take some medications before surgery, you may take them with a small sip of water.
A provider may also prescribe an antibiotic to start the day before your posterior urethral reconstruction.
In general, the following healthcare providers make up your posterior urethral reconstruction team:
An anesthesiologist will first give you general anesthesia before surgery. General anesthesia puts you to sleep. You won’t feel pain or experience any other sensations during surgery.
The most common surgical technique for a posterior urethral reconstruction after an injury is an anastomotic urethroplasty. During this approach, the urologist will:
In some cases, the remaining urethral tissue isn’t long enough to stitch together. In this event, the urologist may “borrow” tissue from somewhere else in your body to rebuild the scarred area that they removed. They most often borrow tissue from your cheeks or behind your lips (buccal mucosa).
Posterior urethral reconstruction may take between three and six hours to complete.
After the procedure, providers will stitch your incisions and cover them with bandages. They’ll also insert a small, soft Foley catheter into your penis. The Foley catheter drains pee from your bladder as your urethra heals.
They may also place a surgical drain around your incision. The drain helps the area heal. Providers usually remove it before you leave the hospital.
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You’ll also stop receiving anesthesia. After a few minutes, you’ll be conscious (awake), but will likely feel groggy. Once you fully wake up, your care team will manage your pain.
You can usually go home once your providers determine you’re healthy enough. But you may need to stay in the hospital for up to 24 hours.
You’ll have follow-up appointments with the urologist as you recover over the next few months. They’ll order tests to make sure you’re healing properly, including:
You’ll use a Foley catheter to pee for three to four weeks as you heal. Once you heal, you should be able to pee as comfortably as you did before you developed a urethral stricture.
A posterior urethral reconstruction helps relieve urethral stricture symptoms. You shouldn’t have to strain or experience pain while peeing. You’re less likely to develop urinary tract infections (UTIs) that may cause inflammation and pain.
And when you can empty your bladder as expected, it helps support your overall bladder and kidney health. This helps prevent future issues, like chronic kidney disease.
In general, posterior urethral reconstruction with an anastomotic urethroplasty technique has good long-term results. But the long-term success depends on the extent of your pelvic trauma.
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Studies show the success rate is between 92% to 97% following reconstruction after a pelvic fracture. After treatment for prostate cancer, the success rate is 70% to 85%.
Side effects of posterior urethral reconstruction may include:
Loss of bladder control is rare when posterior urethral reconstruction treats a stricture after pelvic trauma. But the chance of urinary incontinence is higher after treatment for prostate cancer.
Many people also have erectile dysfunction (ED) after a pelvic fracture or prostate cancer treatment. Posterior urethral reconstruction doesn’t treat ED. You may need additional treatment for it.
Most people experience moderate pain after posterior urethral reconstruction. But healthcare providers will give you pain relievers (analgesics) to limit your discomfort.
Most people can return to light activity after they no longer need a catheter — about three to four weeks. Until then, you should avoid driving and sitting for longer periods. Walking and stairs are OK after a posterior urethral reconstruction. But avoid lifting anything heavier than 20 pounds (about two gallons of water). You should also avoid:
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Avoid all sexual activity for at least eight weeks after posterior urethral reconstruction. This includes masturbation.
Many people can go back to school or desk work a week or two after posterior urethral reconstruction. If you have a more physically demanding job, you should wait until six to eight weeks after surgery.
Call your healthcare provider right away if you have any abnormal symptoms after posterior urethral reconstruction. This includes:
It can be difficult enough to experience a traumatic injury, such as a pelvic fracture or prostate cancer. But the domino effects these conditions may trigger, such as a urethral stricture, can make it seem like you just can’t catch a break. The good news is that posterior urethral reconstruction is a successful treatment option for strictures in your posterior urethra. It won’t treat everything. But you should be able to pee comfortably again.
Talk to a healthcare provider if you develop symptoms of a urethral stricture. They can walk you through the procedure and recovery, as well as answer any questions you may have.
If you have a condition that’s affecting your urinary system, you want expert advice. At Cleveland Clinic, we’ll work to create a treatment plan that’s right for you.
Last reviewed on 11/06/2025.
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