A simplified and unified approach to anterior urethroplasty

Abstract

The management of patients with urethral stricture can be a complex process. However, with the appropriate tools, the urologist experienced in urethral surgery can manage most cases without too much difficulty. Here, we describe three surgical techniques--anastomotic urethroplasty, buccal mucosal graft-onlay urethroplasty and the two-staged Johanson urethroplasty--that, in our experience, can accommodate the majority of patients with urethral stricture and provide excellent long-term results. Diagnosis and evaluation of candidacy for each of the surgical techniques are important aspects of treatment planning, and are also described. The aim of the article is to increase the awareness of the technique and application of these three urethroplasty procedures, which can be implemented by all urologists who actively care for and surgically treat patients with urethral stricture disease.

Complicated urethroplasty: a guide for surgeons

“…2 Generally, a standard buccal mucosa graft onlay urethroplasty is used for short bulbar strictures, a two-staged Johanson urethroplasty is suitable for most penile strictures, and anastomotic urethroplasty is used for urethral distraction defects. 2 the current paper is intended as a companion piece to the previous review.…”

“…2 Generally, a standard buccal mucosa graft onlay urethroplasty is used for short bulbar strictures, a two-staged Johanson urethroplasty is suitable for most penile strictures, and anastomotic urethroplasty is used for urethral distraction defects. 2 the current paper is intended as a companion piece to the previous review. Here, we address the manage ment of complex clinical situations, such as adult urethral stricture disease after childhood hypo spadias repair, panurethral stricture disease, long bulbar urethral strictures, recurrent posterior urethral distraction defects, and stricture disease after prostate cancer treatment.…”

Poor Quality of Life in Patients with Urethral Stricture Treated with Intermittent Self-Dilation

“…The success rate of urethroplasty is 75% to 95% at 6 years. 19 The success rate of transurethral incision of bladder neck contracture is similar. 20 ISD in these cases may not only deny effective reconstructive options but also make subsequent reconstruction more difficult.…”

Current approaches to male anterior urethral reconstruction: what we do and why?

“…Although simple to perform and easily repeated, the success rates of these procedures are low, ranging from 18% for >1 cm penile strictures to 77% for <1 cm bulbar strictures. Urethroplasty is now considered to be a more cost effective approach compared to repeated endoscopic treatments [7,8]. Rourke et al [9] modeled the cost of urethrotomy to be $17,747 per patient compared with $16,444 per patient undergoing primary open urethroplasty.…”