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Updated: May 10, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Our experience, technique and long-term outcomes in the management of posterior urethral strictures
Amit Singh1, Shasanka Shekhar Panda1, Minu Bajpai2
1Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
Insights
This study demonstrates that resection and end-to-end anastomosis is an effective technique for managing posterior urethral strictures in boys, achieving high success rates and good long-term outcomes.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Urethral Stricture Management
Background:
- Posterior urethral stricture is a challenging condition in pediatric patients, often resulting from trauma.
- Effective surgical management is crucial to restore normal voiding function and prevent long-term complications.
Purpose of the Study:
- To present surgical experience and long-term outcomes for posterior urethral stricture management in children.
- To evaluate the efficacy of resection and end-to-end anastomosis using a pre-anal coronal approach.
Main Methods:
- Retrospective analysis of 37 boys with post-traumatic posterior urethral stricture treated between 2000 and 2011.
- Surgical technique involved resection and end-to-end anastomosis, utilizing a pre-anal coronal approach, with optional trans-pubic extension.
- Follow-up included clinical evaluation, micturating cystourethrogram, retrograde urethrogram, and urethroscopy when indicated.
Main Results:
- The pre-anal coronal approach was employed in 78% of cases, combined with a trans-pubic approach in 21%.
- 86% of patients achieved symptom-free status post-surgery, with successful management of failed repairs through dilation or redo urethroplasty.
- No cases of chordee, penile shortening, or urethral diverticula were reported; all patients maintained urinary continence.
Conclusions:
- Resection and end-to-end anastomosis via a pre-anal coronal incision is a viable surgical option for pediatric posterior urethral strictures.
- Extension to a trans-pubic approach is recommended when satisfactory end-to-end anastomosis is challenging.
Purpose:
To share our experience, technique and long-term outcomes in posterior urethral stricture management.
Materials And Methods:
Thirty-seven boys with post-traumatic posterior urethral stricture underwent resection and end-to-end anastomosis through pre-anal coronal approach or in combination with trans-pubic approach from January 2000 to December 2011. Follow up included symptomatic evaluation by micturating cystourethrogram and retrograde urethrogram in all patients, and urethroscopy in patients with voiding symptoms.
Results:
Pre-anal coronal approach was used in 29 (78%) cases and in 8 (21%) cases it was combined with trans-pubic approach. In 33 (89.1%) patients it was first attempt, while in 4 (10.9%) it was redo surgery. Two patients required buccal mucosal graft to bridge the deficient urethra. Patient age was 5-17 years (mean 10.8 years). Mean follow up was 48.5 months (range 6-132 months). Thirty-two (86%) patients were symptom free. Failed repairs were successfully managed by urethral dilation in 3 and by redo urethroplasty in the remaining 2. All patients were continent. There was no chordee, penile shortening or urethral diverticula.
Conclusions:
Resection and end-to-end anastomosis of posterior urethral stricture is possible through pre-anal coronal incision; however, if slightest difficulty is envisaged in creating a satisfactory end-to-end anastomosis, extension to trans-pubic approach should be done.
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