Management of traumatic posterior urethral stricture by one stage perineal repair

Area of Science:

• Urology
• Trauma Surgery
• Reconstructive Surgery

Background:

• Posterior urethral strictures are a common complication of pelvic trauma.
• Previous surgical interventions have variable success rates and potential complications.

Purpose of the Study:

• To evaluate the efficacy of a one-stage perineal repair for post-traumatic posterior urethral strictures.
• To assess the functional outcomes, including continence and potency, following this surgical approach.

Main Methods:

• Ten male patients with posterior urethral strictures underwent a one-stage perineal repair.
• The procedure involved excision of the strictured segment and direct anastomosis of the bulbous urethra to the prostate apex.
• Follow-up ranged from three months to 22 years, with a mean of 22 months.

Main Results:

• Eight out of ten patients achieved excellent results.
• One patient experienced distal urethral narrowing, and another had recurrent stenosis requiring re-operation.
• Urinary continence and erectile function remained unaffected in all patients.

Conclusions:

• The one-stage perineal repair is a viable and effective treatment for most post-traumatic posterior urethral strictures under 2 cm.
• This technique offers a high success rate with preserved functional outcomes.
• The procedure does not compromise options for future surgical interventions if necessary.