[One-stage urethra repair with end-to-end anastomosis]

The direct anastomosis in one session is the method of choice for the treatment of urethral strictures (< 2.5 cm length) when at least three internal urethrotomies have failed. If certain important details are kept in mind about the operative technique (wide anastomosis without tension), suitable suture materials used, and the urinary diversion is done without placing a burden on the anastomosis, the long-term results are good. The direct anastomosis and operative approach can be varied according to the special situation in individual cases. The analysis of 47 patients operated on with direct anastomosis for strictures in the posterior urethra (28 post-traumatic, 9 iatrogenic, 10 postinflammatory) revealed that 83% of the patients had good or satisfactory results, while in 8 patients (17%) the results were poor. The poorist long-term results occurred in post-traumatic strictures in the bulbomembranous part of the urethra connected with complicated pelvic fractures.