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Non-transecting bulbar urethroplasty is favored over transecting techniques

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Abstract

Purpose

To present current evidence supporting the vessel sparing technique to reconstruct bulbar urethral strictures via primary anastomosis.

Methods

English literature review of presented series of transecting and non-transecting bulbar urethroplasty from 2000 to 2018.

Results

Since its introduction in 2007, vessel-sparing excision and primary anastomosis (VS-EPA) has been utilized in multiple centers across the world. Success rates range from 90 to 98%, comparable to traditional transecting EPA. Complication rates and erectile function outcomes are similar or better in VS-EPA, according to recent publications.

Conclusions

Non-transection excision and primary anastomosis is a well-tolerated, highly successful reconstructive option for short bulbar urethral strictures in appropriately selected patients. Results are comparable with traditional transecting anastomosis and mid-term multinational follow-up has proven efficacy and safety of the technique. Further well-designed multi-institutional studies are necessary to determine superiority to traditional EPA in terms of surgical outcomes and erectile function preservation.

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Authors and Affiliations

  1. Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health, 225 Clearfield Ave, Virginia Beach, VA, 23462, USA

    Ramón Virasoro & Jessica M. DeLong

Authors
  1. Ramón Virasoro
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  2. Jessica M. DeLong
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Contributions

RV project development, data collection, data analysis, and manuscript writing/editing. JMD project development, data collection, data analysis, and manuscript writing/editing.

Corresponding author

Correspondence to Ramón Virasoro.

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Conflict of interest

R. Virasoro: consultant Urotronic. J.M. Delong: consultant Urotronic, Sciton.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

This is a review article of the current literature on the topic; hence, no informed consent was necessary, as data collection and analysis did not compromise personal identifiable information.

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Virasoro, R., DeLong, J.M. Non-transecting bulbar urethroplasty is favored over transecting techniques. World J Urol 38, 3013–3018 (2020). https://doi.org/10.1007/s00345-019-02867-8

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  • DOI: https://doi.org/10.1007/s00345-019-02867-8

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