Non-transecting bulbar urethroplasty is favored over transecting techniques.

ABSTRACT

PURPOSE: To present current evidence supporting the vessel sparing technique to reconstruct bulbar urethral strictures via primary anastomosis. METHODS: English literature review of presented series of transecting and non-transecting bulbar urethroplasty from 2000 to 2018. RESULTS: Since its introduction in 2007, vessel-sparing excision and primary anastomosis (VS-EPA) has been utilized in multiple centers across the world. Success rates range from 90 to 98%, comparable to traditional transecting EPA. Complication rates and erectile function outcomes are similar or better in VS-EPA, according to recent publications. CONCLUSIONS: Non-transection excision and primary anastomosis is a well-tolerated, highly successful reconstructive option for short bulbar urethral strictures in appropriately selected patients. Results are comparable with traditional transecting anastomosis and mid-term multinational follow-up has proven efficacy and safety of the technique. Further well-designed multi-institutional studies are necessary to determine superiority to traditional EPA in terms of surgical outcomes and erectile function preservation.