Experiences in transperineal posterior urethral end-to-end anastomosis

Abstract

Objective To summarize surgical technique and complications management in transperineal terminoterminal anastomosis of posterior urethral stricture or atresia. Methods A total of 138 patients with posterior urethral stricture or atresia received transperineal urethral end-to-end anastomosis, of them 119 patients underwent simple anastomosis and 19 patients underwent anastomosis by separating the corporeal bodies. Patients’ micturition was observed and surgical complications were recorded. Results The operations were carried out in all 138 patients and the overall successful rate was 92.75%(128/138) during 2~28 months follow-up. The successful rate of the first urethral end-to-end anastomosis was clearly higher than the rate of one operation history, 95.73%(112/117) vs. 76.19%(16/21, P<0.01). The incidence of postoperative complications, from high to low, was urgent urinary incontinence [18.84%(26/138)], urethral bleeding [9.42%(13/138)], anastomotic stenosis [7.25%(10/138)], incision infection [4.35%(6/138)] and perineal pain [2.90%(4/138)]. Conclusions Transperineal urethral end-to-end anastomosis is still the first choice for the treatment of posterior urethral stricture or atresia, and the failure rate can be obviously reduced by improving surgical techniques. Key words: Urethra; Perineum; Anastomosis, Surgical