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Posterior urethral stricture repair

Transactions of the American Association of Genito-Urinary Surgeons

|January 1, 1978

Summary

This summary is machine-generated.

This study reviews 54 surgeries for urethral strictures, favoring a one-stage perineal approach for bulbomembranous urethra repair. Exteriorization urethroplasty is recommended for complex cases.

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Area of Science:

Urology
Surgical Techniques

Background:

Membranous-prostatic urethral strictures pose significant surgical challenges.
Previous operative failures can lead to long strictures and severe scar tissue, complicating treatment.

Purpose of the Study:

To present surgical experience with 54 operations for membranous-prostatic urethral strictures.
To detail the technique for a preferred one-stage transperineal end-to-end anastomosis.
To recommend alternative surgical approaches based on stricture complexity.

Main Methods:

Review of 54 surgical operations including pubectomy exposure, Badenoch, exteriorization urethroplasty, and transperineal end-to-end anastomosis.
Detailed description of the one-stage transperineal approach technique.
Evaluation of surgical outcomes and indications for each method.

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Main Results:

A total of 54 operations were performed: 7 pubectomy, 6 Badenoch, 31 exteriorization urethroplasty, and 10 one-stage transperineal end-to-end anastomoses.
The one-stage transperineal end-to-end anastomosis is currently the preferred method.
Exteriorization urethroplasty is recommended for long strictures or severe scarring.
Pubectomy approach is reserved for specific cases where lithotomy position is not feasible.

Conclusions:

The one-stage transperineal end-to-end anastomosis is an effective surgical treatment for membranous-prostatic urethral strictures.
Exteriorization urethroplasty provides a viable alternative for complex strictures.
Surgical approach selection should be tailored to stricture length, scar severity, and patient positioning capabilities.