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Transecting or non-transecting: Developing and validating a prediction model for short-segment bulbar urethral
Yubo Gu1,2, Lei Chen3, Jiong Zhang1,2
1Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Asian Journal of Urology
|June 4, 2026
Summary
A new predictive model forecasts whether patients with short-segment bulbar urethral strictures will need a transecting or non-transecting anastomosis. This tool uses etiology and ultrasound scar thickness for preoperative decision-making in urethral stricture management.
Area of Science:
- Urology
- Surgical Innovation
- Medical Diagnostics
Background:
- Short-segment bulbar urethral strictures are commonly managed with excision and primary anastomosis.
- Surgical approach (transecting vs. non-transecting) is often decided intraoperatively.
- Lack of preoperative predictive tools can complicate surgical planning.
Purpose of the Study:
- To develop a predictive model for determining the likelihood of a non-transecting anastomosis in patients with short-segment bulbar urethral strictures.
- To utilize preoperative assessments for forecasting surgical strategy.
- To aid in preoperative decision-making for urethral stricture repair.
Main Methods:
- Retrospective data collection of patients with short-segment bulbar urethral strictures (June 2016 - May 2022).
- Logistic regression analysis incorporating factors significant in univariate analysis (etiology, ventral scar thickness).
- External validation using prospective cohort data (June 2022 - November 2022).
Main Results:
- The final model included etiology and ultrasound-measured ventral scar thickness.
- The model achieved an AUC of 0.91 in the training set and 0.90 in the validation set.
- Validation metrics confirmed good discrimination and calibration of the predictive model.
Conclusions:
- A validated model can predict the anastomosis strategy for bulbar urethral strictures preoperatively.
- The model incorporates etiology and ventral scar thickness for informed surgical planning.
- This tool supports healthcare professionals in preoperative decision-making for urethral stricture management.
