Exploring surgery for UTIs

Written by: Mr Andrew Symes
Published: | Updated: 08/05/2024
Edited by: Karolyn Judge

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.

Surgery for urinary tract infections (UTIs)

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.



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.



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?


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.



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.

By Mr Andrew Symes

Mr Andrew Symes is a highly-regarded consultant urological surgeon based in Brighton and Hove, Hove and Haywards Health. He specialises in benign prostate enlargement, kidney stones and urinary tract infection, alongside bladder problems, prostate cancer and bladder cancer. He practices privately at Nuffield Health Brighton Hospital, The Montefiore Hospital - Spire Healthcare, and Nuffield Health Haywards Heath Hospital, while his NHS base is University Hospitals Sussex NHS Foundation Trust. 

His journey to excellence began with comprehensive training at Guys and St Thomas’s hospitals, where he earned his MDDS and a BSc in clinical anatomy. He was awarded an MD from University College London, where his awarded research focussed on novel gene expression in human prostates. In 2009, Mr Symes received the Keith Yates Gold medal as part of his FRCS at the Royal College of Surgeons. 

Throughout his career, Mr Symes has made significant contributions to the field of urology. His research findings have been published in peer-reviewed journals, and he has presented at international conferences. Moreover, Mr Symes has authored several book chapters, solidifying his reputation as a thought leader in the field. His clinical interests encompass keyhole surgery for large kidney stones, lithotripsy, and minimally invasive surgery for benign prostatic enlargement.

As the clinic lead for stone surgery within the University Hospitals Sussex NHS Foundation Trust, he plays a pivotal role in developing a regional stone service for Sussex. Mr Symes' commitment to cutting-edge treatments is evident in his introduction of the only static lithotripter in Sussex. 

Mr Symes is a proud member of esteemed professional organizations including the British Association of Urological Surgeons (BAUS), BAUS Section of Endourology, and the Royal College of Surgeons.

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