Non‐transecting anastomotic bulbar urethroplasty: a preliminary report

• Published in: BJU international Vol. 109; no. 7; pp. 1090 - 1094
• Main Authors: Andrich, Daniela E., Mundy, Anthony R.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Anastomosis, Surgical; Biological and medical sciences; Humans; Male; Medical sciences; Medical treatment; Middle Aged; Nephrology. Urinary tract diseases; Urethra - surgery; urethral reconstruction; urethral stricture; Urethral Stricture - surgery; urethroplasty; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urologic Surgical Procedures - methods; Young Adult; Nephrology; Urinary system disease; Urethral disease; Report; urethral reconstruction; Surgical anastomosis; Urinary tract disease; Urology; Urethroplasty; Plasty; Treatment; Urethra; Surgery; urethral stricture; Urethral stenosis
• ISSN: 1464-4096; 1464-410X; 1464-410X
• DOI: 10.1111/j.1464-410X.2011.10508.x

Study Type – Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Excision of a stricture and end‐to‐end anastomosis of the two ends is thought to be the best form of treatment for short strictures of the proximal bulbar urethra but involves transecting the main blood supply of the corpus spongiosum and the urethra. This is a preliminary report of achieving the same goal but without transecting the blood supply of the corpus spongiosum of the urethra. OBJECTIVE •  To report our early experience with a novel approach to the excision and end‐to‐end anastomotic repair of bulbar urethral strictures. PATIENTS AND METHODS •  A total of 22 patients underwent excision and end‐to‐end anastomosis of a proximal bulbar urethral stricture using a technique in which the corpus spongiosum is not transected, so as to maintain its blood supply intact. •  The range of follow‐up was 6–21 months and for 16 patients the follow up was ≥1year. RESULTS •  At 1 year of follow‐up there was no evidence of a recurrent stricture on symptomatic assessment or uroflowmetry in the 16 patients. •  On urethrography one patient has a urethral calibre 80% of normal. In the other 15 the calibre is normal or greater than normal. CONCLUSION •  The non‐transecting anastomotic bulbar urethroplasty technique used appears to give results that are as good as those of traditional anastomotic urethroplasty with less surgical trauma.