The efficacy of non-transecting spongiosum end to end anastomosis of urethra for treatment of posterior urethral stricture

Abstract

Objective To report preliminary experiences with a novel procedure of end-to-end anastomotic repairment of posterior urethral strictures. Methods From January 2011 to December 2014, a total of 26 patients with posterior urethral strictures(2 patients with exist simultaneously anterior urethral stricture)were treated. The mean age was 43 years (rang 13-83 years). The etiology of urethral strictures were trauma in 23 patients and iatrogenic causes in 3 patients. The mean length of urethral stricture was 2 cm (rang 1-3 cm). Suprapubic cystostomies were performed in all 26 patients. All patients accepted the non-transecting spongiosum bulbar-membranous end to end anastomosis. During the operation, the perineal incision was made. The dorsal stricture urethra was incised, extending to the 1.5 cm normal urethra at each side. Then, the interrupted end to end suture was performed with 3-0 absorbable suture. Results The mean surgical time was 55 minutes in 24 patients(45-65 minutes). There was no evidence of wound infection or urethrocutaneous fistula during perioperation period. The mean follow-up time for 26 patients were 16 months(4 months-3 years). There was no recurrent stricture on symptomatic assessment or uroflowmetry. The patients voided well with mean peak flows rate 25.4 ml/s (16.8-59.1 ml/s). Urethrography showed that each patient had a patent urethra with adequate lumen. Conclusions Non-transecting spongiosum end to end anastomosis of urethra technique could retain spongiosal blood support. In present preliminary study, it appears to give similar results as those of traditional anastomotic urethroplasty. Key words: Posterior urethral stricture; Urethral reconstruction; Non-transecting corpus spongiosum