Editorial Comment

Abstract

This is a stunningly large series of urethral distraction injuries repaired at 1 referral center. It is a welcome analysis, and provides insight into several important questions. (1) The success rate of redo perineal urethroplasty: the success rate of second urethroplasty is 83% compared with 90% in unoperated cases. (2) Timing of failures: most failures occur before 6 months. (3) Complication rate: in this series, there was new impotence in 12% of cases (not reported in other series). (4) Higher failures in children: this series confirms that children have a 7% higher failure rate than adults. There are some other conclusions, however, that are less robust, and deserving of some unwincing examination. Transperineal Bulboprostatic Anastomosis in Patients With Simple Traumatic Posterior Urethral Strictures: A Retrospective Study from a Referral Urethral CenterUrologyVol. 74Issue 5PreviewTo evaluate the results of ancillary procedures for posterior urethroplasty and compare them with the severity of urethral stricture. Full-Text PDF ReplyUrologyVol. 74Issue 5PreviewThis is an interesting issue for discussion. First, we will discuss urethral lengthening. It may be unusual for specialists to require maneuvers such as corporeal rerouting or pubectomy. We also suggest distal mobilization of the bulbar urethra from the external sphincter to the penoscrotal junction, because this is known to provide 4-5 cm of the urethral length. This step alone should be sufficient to allow tension-free anastomosis in most patients, because in 76%-78% of patients the defect was < 3 cm. Full-Text PDF