title: The advantages of the ventral approach to bulbar urethroplasty.
abstract: BACKGROUND
  Several surgical techniques have been described for the treatment of bulbar urethral strictures, and the main goal of modern surgery is to reduce morbidity and obtain the best outcome with the fewest complications. Currently, the superiority of one surgical technique over another has not yet been clearly defined.
  
  
  METHODS
  We analysed the historical background, advantages and disadvantages of several urethral approaches and graft placements, with the aim of focusing on the advantages of the ventral approach.
  
  
  CONCLUSIONS
  For short bulbar strictures (<2 cm) the traditionally advocated method is excision and end-to-end anastomosis, whilst for longer strictures, in the last decade, the patch graft urethroplasty has been used, with buccal mucosa advocated as the standard material of substitution. Our analysis showed that the approach (dorsal vs. ventral) to the bulbar urethral lumen and the location of the patch (dorsal vs. ventral) are contentious issues. Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications. The graft urethroplasty using the ventral approach fulfils these requirements.
authors.affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Palminteri
authors.affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Berdondini
authors.affiliation: Department of Obstetrics and Gynecology Sciences and Urologic Sciences, 'La Sapienza' University, Rome, Italy.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Di Pierro
keywords: Approach; Bulbar urethral strictures; Dorsal; Urethroplasty; Ventral