title: Transperineal bulbo-prostatic anastomosis for posterior urethral stricture associated with false passage: a single-centre experience.
abstract: OBJECTIVE
  • To evaluate the management of traumatic posterior urethral stricture associated with false passage, as this remains a challenge for urologists.
  
  
  METHODS
  • From January 2000 to February 2010, 19 patients (mean (range) age 34 [25-52] years) with traumatic posterior urethral obliteration associated with false passage were evaluated and treated at our centre. • All patients underwent perineal excision and primary anastomotic urethroplasty using cystoscopy by the suprapubic route to insert a guidewire into the original bladder neck, allowing exposure of the normal posterior urethra. • Patients underwent voiding cysto-urethrography 1 month after the procedure. When symptoms of decreased force of stream were present and uroflowmetry was <15 mL/s, urethrography and urethroscopy were repeated. • Clinical outcome was considered a failure when any postoperative instrumentation was needed, including dilatation.
  
  
  RESULTS
  • The mean (range) follow-up was 12 (9-14) months. The overall success rate was 84%. • Three patients (16%) with persistent voiding difficulty developed a short anastomotic stricture 1-3 months after surgery. • The mean maximum urinary flow rate after surgery was 20.01 mL/s and no patient had urinary incontinence.
  
  
  CONCLUSIONS
  • The preoperative use of flexible cystoscopy via the suprapubic route represented a successful key point of urethroplasty for posterior urethral stricture associated with false passage.
authors.affiliation: Department of Urology, Shanghai 6th Hospital, Shanghai, China. jamesqfu@yahoo.com.cn
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.forename: Jiong
authors.initials: J
authors.lastname: Zhang
authors.forename: Ying-long
authors.initials: YL
authors.lastname: Sa
authors.forename: San-bao
authors.initials: SB
authors.lastname: Jin
authors.forename: Yue-min
authors.initials: YM
authors.lastname: Xu
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D003558:Cystoscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*