[A method for joining the ends of the resected urethra]

In spite of the fact that the operations after B. N. Khol'tsov, P. D. Solovov, and V. I. Rusakov have found a wide recognition and use, the rate of complications and poor results remains still high, reaching 3-29%. The authors consider that one of the reasons for poor outcomes in such operations is evolving urethral ischemia at the site of anastomosis, which is caused by compression of tissues with suturing material with the routine suturing of urethral ends through all its layers. The experiment with the male dogs and human cadavers provided evidence for this assumption. The mathematical calculation indicated that with the sutures applied, over 12-16% of the urethral tissue volume became ischemic at the site of anastomosis. A new technique was proposed to attach the ends of the resected urethra, which eliminates the suture of the urethral ends through all the layers. The essence of the technique is that after resection, the ends of the urethra are opposed and fixed with the outer layers without suturing the urethra via all the layers with 6 stitches. Twenty nine patients were operated on in this fashion. Twenty eight patients were discharged with recovered micturition. A relapse occurred in one patient with inflammatory urethral stricture. For 3 months to 3 years, 22 subjects were examined, another patient had a relapse 3 months following surgery. The two patients were reoperated, with a good effect. The remaining patients reported normal micturition and presented no complaints.