Skip to main content

Advertisement

SpringerLink
Log in

International multi-institutional experience with the vessel-sparing technique to reconstruct the proximal bulbar urethra: mid-term results

  • Original Article
  • Published:
World Journal of Urology Aims and scope

Abstract

Objective

To present mid-term outcomes from an international, multi-institutional cohort of patients undergoing vessel-sparing excision and primary anastomosis urethroplasty for the reconstruction of the anterior urethra.

Materials and methods

From June 2003 to December 2011, 68 patients underwent vessel-sparing anterior urethral reconstruction at five different international institutions using the vessel-sparing technique described by Jordan et al. (J Urol 177(5):1799–1802, 2007).

Results

Patients’ age range was from 3 to 82 years (mean 51.2). Stricture length ranged from 1 to 3 cm (mean 1.78). After a mean follow-up of 17.6 months, 95.6 % of patients had a widely patent urethral lumen. Three patients failed the procedure, requiring either direct vision internal urethrotomy or urethral dilation, after which all were free of symptoms and did not require further instrumentation. Complications were minimal and as expected following open urethroplasty.

Conclusion

Preservation of blood supply is a noble pursuit in surgery; however, it can be technically difficult and often requires more time and effort. This vessel-sparing technique for anterior urethral reconstruction is reproducible and appears to be reliable in this international cohort. Larger studies and longer follow-up are needed to support these encouraging results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Andrich DE, Dunglison N, Greenwell TJ, Mundy AR (2003) The long-term results of urethroplasty. J Urol 170(1):90–92

    Article  CAS  PubMed  Google Scholar 

  2. Eltahawy EA, Virasoro R, Schlossberg SM, McCammon KA, Jordan GH (2007) Long-term followup for excision and primary anastomosis for anterior urethral strictures. J Urol 177(5):1803–1806

    Article  PubMed  Google Scholar 

  3. Micheli E, Ranieri A, Peracchia G, Lembo A (2002) End-to-end urethroplasty: long-term results. BJU Int 90(1):68–71

    Article  CAS  PubMed  Google Scholar 

  4. Morey AF, Kizer WS (2006) Proximal bulbar urethroplasty via extended anastomotic approach–what are the limits? J Urol 175(6):2145–2149 discussion 9

    Article  PubMed  Google Scholar 

  5. Santucci RA, Mario LA, McAninch JW (2002) Anastomotic urethroplasty for bulbar urethral stricture: analysis of 168 patients. J Urol 167(4):1715–1719

    Article  PubMed  Google Scholar 

  6. Wein AJ, Kavoussi LR, Campbell MF. Campbell-Walsh urology/editor-in-chief, Alan J. Wein; [editors, Louis R. Kavoussi… et al.]. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012

  7. Jordan GH, Eltahawy EA, Virasoro R (2007) The technique of vessel sparing excision and primary anastomosis for proximal bulbous urethral reconstruction. J Urol 177(5):1799–1802

    Article  PubMed  Google Scholar 

  8. Gur U, Jordan GH (2008) Vessel-sparing excision and primary anastomosis (for proximal bulbar urethral strictures). BJU Int 101(9):1183–1195

    Article  PubMed  Google Scholar 

  9. DeCastro BJ, Anderson SB, Morey AF (2002) End-to-end reconstruction of synchronous urethral strictures. J Urol 167(3):1389

    Article  PubMed  Google Scholar 

  10. DeLong J, Buckley J (2013) Patient-reported outcomes combined with objective data to evaluate outcomes after urethral reconstruction. Urology 81(2):432–436

    Article  PubMed  Google Scholar 

  11. Blaschko SD, Sanford MT, Cinman NM, McAninch JW, Breyer BN (2013) De novo erectile dysfunction after anterior urethroplasty: a systematic review and meta-analysis. BJU Int 112(5):655–663

    Article  PubMed Central  PubMed  Google Scholar 

  12. Andrich DE, Mundy AR (2012) Non-transecting anastomotic bulbar urethroplasty: a preliminary report. BJU Int 109(7):1090–1094

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest. Consultant and proctor American Medical System (McCammon).

Ethical standard

Institutional review board approval was obtained prior to performing this chart review and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Author information

Authors and Affiliations

  1. Eastern Virginia Medical School, Norfolk, VA, USA

    Ramón Virasoro, Jack M. Zuckerman, Kurt A. McCammon, Jessica M. DeLong, Jeremy B. Tonkin & Gerald H. Jordan

  2. Centro de Educación Médica e Investigaciones Clínicas “Dr. Norberto Quirno” (CEMIC), Buenos Aires, Argentina

    Leandro Capiel & Agustín R. Rovegno

  3. Hospital Italiano, Buenos Aires, Argentina

    Gabriel Favre & Carlos R. Giudice

  4. University of Arkansas for Medical Sciences, Arkansas, AR, USA

    Ehab A. Eltahawy

  5. Meir Medical Center, Kfar Sava, Israel

    Uri Gur

  6. Department of Urology, Eastern Virginia Medical School, 225 Clearfield Avenue, Virginia Beach, VA, 23462, USA

    Ramón Virasoro

Authors
  1. Ramón Virasoro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jack M. Zuckerman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kurt A. McCammon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jessica M. DeLong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeremy B. Tonkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leandro Capiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Agustín R. Rovegno
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gabriel Favre
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Carlos R. Giudice
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ehab A. Eltahawy
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Uri Gur
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Gerald H. Jordan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ramón Virasoro.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Virasoro, R., Zuckerman, J.M., McCammon, K.A. et al. International multi-institutional experience with the vessel-sparing technique to reconstruct the proximal bulbar urethra: mid-term results. World J Urol 33, 2153–2157 (2015). https://doi.org/10.1007/s00345-015-1512-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-015-1512-9

Keywords

Search

Navigation