Non-Transecting Bulbar Urethroplasty

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Edi Wibowo, Paksi Satyagraha

2025 Surgical Atlas of Urethroplasty Book chapter Cited by 0 Quartile

Abstract

Excision and primary anastomosis (EPA) is a standardized, repeatable procedure with an expected long-term success rate of 90-98.6% [1]. However, a full thickness transection of the corpus spongiosum, and the dual urethral blood supply within it, is unnecessary for some cases. Recent discussions in the reconstructive urological community have sparked a debate on the optimal management of bulbar urethral strictures, particularly concerning whether to transect the bulbar urethra or not in non-traumatic cases. Therefore, Mundy et al. (2015) developed a modified technique of non-transecting anastomotic bulbar urethroplasty. In this technique, a dorsal approach is used and the stricturotomy is carried out through the thinnest part of the spongiosum, therefore there is limited vascular compromise to the urethra [2]. This technique aims to achieve similar success rates as transecting EPA while avoiding the potential morbidity associated with dividing the corpus spongiosum in non-traumatic bulbar strictures. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2024.

Affiliations

Department of Urology, Saiful Anwar General Hospital, Medical Faculty Universitas Brawijaya, Malang, Indonesia