title: International multi-institutional experience with the vessel-sparing technique to reconstruct the proximal bulbar urethra: mid-term results.
abstract: OBJECTIVE
  To present mid-term outcomes from an international, multi-institutional cohort of patients undergoing vessel-sparing excision and primary anastomosis urethroplasty for the reconstruction of the anterior urethra.
  
  
  METHODS
  From June 2003 to December 2011, 68 patients underwent vessel-sparing anterior urethral reconstruction at five different international institutions using the vessel-sparing technique described by Jordan et al. (J Urol 177(5):1799-1802, 2007).
  
  
  RESULTS
  Patients' age range was from 3 to 82 years (mean 51.2). Stricture length ranged from 1 to 3 cm (mean 1.78). After a mean follow-up of 17.6 months, 95.6 % of patients had a widely patent urethral lumen. Three patients failed the procedure, requiring either direct vision internal urethrotomy or urethral dilation, after which all were free of symptoms and did not require further instrumentation. Complications were minimal and as expected following open urethroplasty.
  
  
  CONCLUSIONS
  Preservation of blood supply is a noble pursuit in surgery; however, it can be technically difficult and often requires more time and effort. This vessel-sparing technique for anterior urethral reconstruction is reproducible and appears to be reliable in this international cohort. Larger studies and longer follow-up are needed to support these encouraging results.
authors.affiliation: Eastern Virginia Medical School, Norfolk, VA, USA. viravira@yahoo.com.|Department of Urology, Eastern Virginia Medical School, 225 Clearfield Avenue, Virginia Beach, VA, 23462, USA. viravira@yahoo.com.
authors.forename: Ramón
authors.initials: R
authors.lastname: Virasoro
authors.affiliation: Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Zuckerman
authors.affiliation: Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Kurt A
authors.initials: KA
authors.lastname: McCammon
authors.affiliation: Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: DeLong
authors.affiliation: Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Tonkin
authors.affiliation: Centro de Educación Médica e Investigaciones Clínicas "Dr. Norberto Quirno" (CEMIC), Buenos Aires, Argentina.
authors.forename: Leandro
authors.initials: L
authors.lastname: Capiel
authors.affiliation: Centro de Educación Médica e Investigaciones Clínicas "Dr. Norberto Quirno" (CEMIC), Buenos Aires, Argentina.
authors.forename: Agustín R
authors.initials: AR
authors.lastname: Rovegno
authors.affiliation: Hospital Italiano, Buenos Aires, Argentina.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Favre
authors.affiliation: Hospital Italiano, Buenos Aires, Argentina.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Giudice
authors.affiliation: University of Arkansas for Medical Sciences, Arkansas, AR, USA.
authors.forename: Ehab A
authors.initials: EA
authors.lastname: Eltahawy
authors.affiliation: Meir Medical Center, Kfar Sava, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Gur
authors.affiliation: Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Jordan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D055815:Young Adult
keywords: Excision and primary anastomosis; Urethral stricture; Vessel sparing