Abstract: PD34-02
Sources of Funding: none

Introduction

The non-transecting approach to bulbar urethroplasty was popularised by Jordan et al and Andrich et al and is being used by an increasing number of surgeons. We reviewed our experience with this procedure.

Methods

Between January 2009 and December 2015, 125 men with a mean age of 42 (range 16-77) years have undergone a "non-transecting approach" to their bulbar urethral stricture. 112 patients had idiopathic strictures, 5 had iatrogenic strictures, 5 had urethral trauma, 5 were post-radical prostatectomy strictures and 3 were post-TURP strictures. In the same timeframe, 36 transecting anastomotic urethroplasties were performed for straddle injuries and 201 dorsal patch bulbar urethroplasty were performed for long urethral strictures. _x000D_ _x000D_ 58 patients had a non-transecting mucosal anastomotic repair, 48 patients had a non-transecting augmented urethroplasty using buccal graft and 19 underwent a Heineke-Mikulicz-type stricturoplasty alone. _x000D_ _x000D_ All patients underwent clinical assessment and flow rate studies and urethrograms prospectively. _x000D_

Results

Clinically, 116 patients (92.8%) were happy with the result of their surgery, 2 were unhappy (but had normal flow rates) and there were 4 failures, who all underwent revisional surgery. 3 patients were lost to follow-up. The mean post-operative peak flow rate was 34.9mls per second, in 102 patients. 7 patients had flow rates of less than 15mls per second, including the 4 failures, 3 patients voided less than 100mls and where therefore not assessable and 13 patients refused a flow rate study or were lost to follow-up (n=3). On antegrade/retrograde urethrogram, 120 were normal, 1 had a slightly reduced calibre but had a normal flow rate, there were 4 recurrent strictures and 9 refused or were lost to follow-up (n=3). _x000D_ _x000D_ Overall 118 of 122 patients (96%) were a success clinically by radiology and flow rate study as well as subjectively. _x000D_

Conclusions

The non-transecting approach to bulbar urethroplasty gives results that are at least as good as previously reported for excision and primary anastomosis or augmented anastomotic urethroplasty or dorsal patch urethroplasty. The increasingly widespread use of this procedure is therefore entirely justified.

Funding

none