title: Non-transecting bulbar urethroplasty.
abstract: Excision and end-to-end anastomosis (EPA) has been the preferred urethroplasty technique for short bulbar strictures and is associated with an excellent functional outcome. Driven by concerns over the potential morbidity associated with dividing the urethra, therefore compromising spongiosal blood flow, as well as spongiofibrosis being superficial in the majority of non-traumatic bulbar strictures, the non-transecting technique for bulbar urethroplasty has been developed with the aim of achieving the same success as EPA without the morbidity associated with transection. This manuscript highlights the fundamental principles underlying the ongoing debate-transection or non-transection of the strictured bulbar urethra? The potential advantages of avoiding dividing the corpus spongiosum of the urethra are discussed. The non-transecting anastomotic procedure together with its various modifications are decribed in detail. Our experience with this technique is presented. Non-transecting excision of spongiofibrosis with preservation of well vascularised underlying spongiosum provides an excellent alternative to dividing the urethra during urethroplasty for short non-traumatic proximal bulbar strictures.
authors.affiliation: Reconstructive Urology Unit, University College London Hospital, London NW1 2BU, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Bugeja
authors.affiliation: Reconstructive Urology Unit, University College London Hospital, London NW1 2BU, UK.
authors.forename: Daniela E
authors.initials: DE
authors.lastname: Andrich
authors.affiliation: Reconstructive Urology Unit, University College London Hospital, London NW1 2BU, UK.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Mundy
keywords: Anterior urethral strictures; urethral reconstruction; urethroplasty
references.citation: BJU Int. 2005 Oct;96(6):921-44
references.pmid: 16153236
references.citation: BJU Int. 2012 Apr;109(7):1090-4
references.pmid: 21933325
references.citation: Eur Urol. 2008 Apr;53(4):828-33
references.pmid: 18243497
references.citation: Eur Urol. 2011 May;59(5):797-814
references.pmid: 21353379
references.citation: J Urol. 2010 Dec;184(6):2395-9
references.pmid: 20952000
references.citation: Curr Opin Urol. 2012 Nov;22(6):474-7
references.pmid: 22825459
references.citation: Nat Clin Pract Urol. 2005 Nov;2(11):538-45
references.pmid: 16474597
references.citation: J Urol. 2003 Jul;170(1):90-2
references.pmid: 12796652
references.citation: BJU Int. 2008 May;101(9):1183-95
references.pmid: 18399836
references.citation: J Urol. 2001 May;165(5):1496-501
references.pmid: 11342904
references.citation: J Urol. 1997 Jan;157(1):98-101
references.pmid: 8976225
references.citation: J Urol. 2007 Dec;178(6):2470-3
references.pmid: 17937939
references.citation: BJU Int. 2007 Aug;100(2):397-402
references.pmid: 17617144
references.citation: J Urol. 2004 Jul;172(1):275-7
references.pmid: 15201793
references.citation: J Urol. 2007 Jun;177(6):2211-5; discussion 2215-6
references.pmid: 17509322
references.citation: Int Urol Nephrol. 1976;8(1):55-61
references.pmid: 965199
references.citation: J Urol. 2004 Aug;172(2):580-3
references.pmid: 15247736
references.citation: Urology. 2014 Mar;83(3 Suppl):S23-6
references.pmid: 24373726
references.citation: J Urol. 2010 Feb;183(2):657-61
references.pmid: 20018319
references.citation: BJU Int. 2011 Jan;107(1):6-26
references.pmid: 21176068
references.citation: Eur Urol. 2011 Jul;60(1):60-8
references.pmid: 21419566
references.citation: Eur Urol. 2010 Jul;58(1):33-41
references.pmid: 20106587
references.citation: J Urol. 2007 May;177(5):1799-802
references.pmid: 17437823
references.citation: J Urol. 2009 Oct;182(4):1266-70
references.pmid: 19683309
references.citation: Inflamm Bowel Dis. 2013 Mar-Apr;19(4):704-11
references.pmid: 23448794
references.citation: Int J Urol. 2005 Jun;12 (6):558-62
references.pmid: 15985078
references.citation: J Urol. 2007 May;177(5):1803-6
references.pmid: 17437824
references.citation: Minerva Urol Nefrol. 2010 Dec;62(4):371-6
references.pmid: 20944538
references.citation: Urology. 2012 Apr;79(4):917-21
references.pmid: 22309783
references.citation: Eur Urol. 2013 Nov;64(5):777-82
references.pmid: 23664422
references.citation: BJU Int. 2001 Sep;88(4):385-9
references.pmid: 11564027
references.citation: J Urol. 2002 Apr;167(4):1715-9
references.pmid: 11912394