Transpubic urethroplasty for membranous urethral strictures

Area of Science:

• Urology
• Surgical Innovation
• Reconstructive Surgery

Background:

• Traumatic membranous urethral strictures present a significant reconstructive challenge.
• Traditional surgical approaches may involve complex dissections and potential complications.

Purpose of the Study:

• To evaluate the efficacy and outcomes of the transpubic urethroplasty approach for traumatic membranous urethral strictures.
• To assess the functional results, including stricture recurrence and urinary continence, following this surgical technique.

Main Methods:

• Six patients with traumatic membranous urethral strictures underwent urethroplasty using the transpubic approach.
• This involved resection of a wedge of the symphysis pubis to facilitate the procedure.
• Postoperative outcomes regarding stricture resolution and urinary continence were meticulously recorded.

Main Results:

• Three patients achieved complete stricture resolution without further intervention.
• Two patients required only early postoperative urethral dilatation.
• One patient experienced ongoing stricture requiring intermittent dilatation.
• Four patients maintained complete urinary continence.
• One patient had mild stress incontinence, and another had incontinence due to a neurogenic bladder.

Conclusions:

• The transpubic urethroplasty approach offers excellent surgical exposure for urethral reconstruction.
• This technique demonstrates a favorable success rate in managing traumatic membranous urethral strictures with minimal morbidity.
• The approach facilitates an easy under-vision anastomosis, contributing to successful outcomes.