Related Experiment Video
Updated: Mar 30, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
The advantages of the ventral approach to bulbar urethroplasty
Enzo Palminteri1, Elisa Berdondini1, Giovanni Battista Di Pierro2
1Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
Background:
Several surgical techniques have been described for the treatment of bulbar urethral strictures, and the main goal of modern surgery is to reduce morbidity and obtain the best outcome with the fewest complications. Currently, the superiority of one surgical technique over another has not yet been clearly defined.
Methods:
We analysed the historical background, advantages and disadvantages of several urethral approaches and graft placements, with the aim of focusing on the advantages of the ventral approach.
Conclusions:
For short bulbar strictures (<2 cm) the traditionally advocated method is excision and end-to-end anastomosis, whilst for longer strictures, in the last decade, the patch graft urethroplasty has been used, with buccal mucosa advocated as the standard material of substitution. Our analysis showed that the approach (dorsal vs. ventral) to the bulbar urethral lumen and the location of the patch (dorsal vs. ventral) are contentious issues. Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications. The graft urethroplasty using the ventral approach fulfils these requirements.
