Outcome of non-transected anastmotic urethroplasty for management of short bulbar urethral stricture

Elsayed, Mostafa Mahmoud; Abd El Wahab, Atef. Gammal; Sallem, Essam; Riad, Ahmed

doi:10.21608/smj.2019.47689

Outcome of non-transected anastmotic urethroplasty for management of short bulbar urethral stricture

Document Type : Original Article

Authors

Department of Urology, Faculty of Medicine, Sohag University.

10.21608/smj.2019.47689

Abstract

Excision and end-to-end anastomosis (EPA) has been the preferred urethroplasty technique for short bulbar strictures and is associated with an excellent functional outcome. Driven by concerns over the potential morbidity associated with dividing the urethra, therefore compromising spongiosal blood flow, as well as spongiofibrosis being superficial in the majority of non-traumatic bulbar strictures, the nontransecting
technique for bulbar urethroplasty has been developed with the aim of achieving the same success as EPA without the morbidity associated with the transaction. This manuscript highlights the fundamental principles underlying the ongoing debate—transaction or non-transection of the strictured bulbar urethra? The potential advantages of avoiding dividing the corpus spongiosum of the urethra are discussed. The non-transecting anastomotic procedure together with its various modifications is described in detail. Our experience with this technique is presented. Non-transecting excision of spongiofibrosis with preservation of well vascularised underlying spongiosum provides an excellent alternative to dividing the urethra during urethroplasty for short non-traumatic proximal bulbar stricture.

Main Subjects

Urology.

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