title: SIU/ICUD Consultation on Urethral Strictures: Anterior urethra--primary anastomosis.
abstract: The management of primary and recurrent bulbar urethral stricture disease has been a source of controversy with the choice being between endoscopic urethrotomy and open urethroplasty. Further debate exists with regard to the choice of urethroplasty--either excision and primary anastomosis (EPA) or augmentation with a graft or flap. Using PubMed, a 35-year literature search was conducted (1975-2010) for peer-reviewed articles on bulbar strictures treated using EPA. Exclusions included articles with <10 patients, duplications, reviews, or in which the cohort was mixed and the data could not be separately analyzed. Seventeen articles fulfilled the criteria with a total of 1234 patients. Overall success was 93.8%. Reported complications were <5%, and there was no evidence of persistent loss of sexual function. The authors conclude that EPA is associated with a high success rate with low complication rate. Our recommendation is that it should be performed in patients with short isolated bulbar strictures, when expected success rates of other procedures are <90%.
authors.affiliation: Department of Urology, Southwestern Medical School, Dallas, TX.
authors.forename: Allen F
authors.initials: AF
authors.lastname: Morey
authors.affiliation: Department of Urology, St. George's Hospital, London, United Kingdom. Electronic address: Nick.Watkin@stgeorges.nhs.uk.
authors.forename: Nick
authors.initials: N
authors.lastname: Watkin
authors.affiliation: Department of Urology, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Shenfeld
authors.affiliation: Ain Shams University Hospitals, Cairo, Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Eltahawy
authors.affiliation: Department of Urology, Hospital Italiano, Buenos Aires, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Giudice
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D032921:Consensus; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D008297:Male; D012008:Recurrence; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*