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Vessel-sparing Excision and Primary Anastomosis

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

The Nontransecting Approach to Bulbar Urethroplasty.

Stella Ivaz¹, Simon Bugeja¹, Anastasia Frost¹

¹Institute of Urology at UCLH, 16-18 Westmoreland Street, London W1g 8PH, UK.

The Urologic Clinics of North America

|December 3, 2016

Summary

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Open urethroplasty versus endoscopic urethrotomy for recurrent urethral stricture in men: the OPEN RCT.

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Excision and primary anastomosis (EPA) is a standard treatment for bulbar urethral strictures. While effective, this procedure transects the corpus spongiosum (CS), potentially leading to sexual dysfunction.

Area of Science:

Urology
Surgical Innovation
Sexual Health

Background:

Bulbar urethral strictures are commonly treated with excision and primary anastomosis (EPA).
This surgical approach involves transecting the corpus spongiosum (CS), which disrupts its blood supply.

Purpose of the Study:

To evaluate the established treatment for bulbar urethral strictures.
To highlight the potential adverse effects of the standard surgical technique.

Main Methods:

Review of existing evidence and clinical opinion regarding EPA for bulbar urethral strictures.
Analysis of the anatomical and physiological consequences of corpus spongiosum (CS) transection during EPA.

Main Results:

Excision and primary anastomosis (EPA) demonstrates a high success rate in curing bulbar urethral strictures.

Keywords:

Urethral reconstruction Urethral stricture Urethroplasty

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Transection of the corpus spongiosum (CS) during EPA is associated with a significant risk of sexual dysfunction.

Other adverse consequences may arise from the disruption of blood flow within the CS.

Conclusions:

While EPA is effective for treating bulbar urethral strictures, its impact on sexual health requires consideration.
The transection of the corpus spongiosum (CS) is a critical factor contributing to potential post-operative complications.