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Excision and primary anastomosis for anterior urethral stricture
James R Jezior1, Steven M Schlossberg
1Department of Urology, Eastern Virginia Medical School, PO Box 1980, Norfolk, VA 23501, USA.
The Urologic Clinics of North America
|October 10, 2002
Summary
Excision with spatulated primary anastomosis (EPA) offers a 90-95% success rate for short bulbar urethral strictures. Careful patient selection and surgical technique are key to avoiding complications and achieving durable results.
Area of Science:
- Urology
- Surgical Reconstruction
Background:
- Bulbar urethral strictures can significantly impact quality of life.
- Surgical intervention is often necessary for effective treatment.
Purpose of the Study:
- To evaluate the efficacy and outcomes of excision with spatulated primary anastomosis (EPA) for short bulbar urethral strictures.
- To identify factors influencing success and potential complications.
Main Methods:
- Patient selection based on detailed history, physical examination, and radiographic staging.
- Surgical technique involving precise urethral excision and tension-free anastomosis.
Main Results:
- EPA demonstrates high success rates (90-95%) in selected patients.
- Inadequate excision and excessive anastomotic tension are primary causes of failure.
- Complications such as infections, chordee, and erectile dysfunction are infrequent.
Conclusions:
- EPA is a highly effective and durable reconstructive option for short bulbar urethral strictures.
- Meticulous surgical technique and patient selection are crucial for optimal outcomes.
- EPA should be strongly considered as a first-line treatment.