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Related Experiment Video

Updated: Jan 30, 2026

Vessel-sparing Excision and Primary Anastomosis
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Vessel-sparing Excision and Primary Anastomosis.

Wesley Verla1, Willem Oosterlinck2, Marjan Waterloos2

  • 1Department of Urology, Ghent University Hospital; Wesley.Verla@UGent.be.

Journal of Visualized Experiments : Jove
|January 22, 2019
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Summary

Vessel-sparing excision and primary anastomosis (vsEPA) offers high success rates for urethral strictures. This technique reduces surgical trauma, potentially lowering risks of erectile dysfunction and glans ischemia compared to traditional methods.

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Area of Science:

  • Urology
  • Surgical Technique
  • Reconstructive Surgery

Background:

  • Urethroplasty is the gold standard for urethral strictures, with excision and primary anastomosis (EPA) recommended for short bulbar or posterior strictures.
  • Traditional transecting EPA (tEPA) involves full-thickness transection of the corpus spongiosum, which may be unnecessary.
  • A vessel-sparing approach (vsEPA) was proposed to minimize surgical trauma and preserve urethral vascularity.

Purpose of the Study:

  • To provide a detailed, step-by-step overview of the vessel-sparing excision and primary anastomosis (vsEPA) technique.
  • To outline the surgical management of patients with isolated short bulbar or posterior urethral strictures using vsEPA.
  • To report the surgical outcomes of the vsEPA technique in a patient cohort.

Main Methods:

  • A retrospective analysis of 117 patients undergoing vsEPA for isolated short bulbar or posterior urethral strictures.
  • Detailed description of the step-by-step surgical technique for vsEPA.
  • Separate analysis of outcomes for bulbar (n=91) and posterior (n=26) stricture groups.

Main Results:

  • Overall success rates for vsEPA were high, with 93.4% for the bulbar group and 88.5% for the posterior group.
  • The study outlines a protocol for managing specific urethral strictures with vsEPA.
  • Low complication rates were observed with the vsEPA technique.

Conclusions:

  • Vessel-sparing excision and primary anastomosis (vsEPA) is an effective treatment for isolated short bulbar and posterior urethral strictures.
  • The vsEPA technique achieves excellent success rates and low complication rates.
  • vsEPA offers potential benefits by reducing surgical trauma compared to traditional methods.