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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
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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
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.
- 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.
