Vol. 118, November Printed in U.SA.
THE JOURNAL OF UROLOGY
Copyright © 1977 by The Williams & Wilkins Co.
DIRECT URETHRA-BLADDER NECK ANASTOMOSIS IN THE SURGICAL CORRECTION OF POSTERIOR URETHRAL STRICTURES NHIEP TANG* From the Department of Urology, Memorial Medical Center, Savannah, Georgia
ABSTRACT
A direct anastomosis of the urethra and bladder neck is suggested for posterior urethral strictures, especially high lesions. The technique is described, and its advantages and complications are discussed. Strictures of the posterior urethra pose a difficult therapeutic problem, which many have tried to solve with varying degrees of success. A periurethral approximation suture over a stent catheter after a scar excision often results in a recurring stricture. Partial pubectomy or pubic symphysiotomy offers a better approach to the posterior urethra for scar removal and a technically satisfying end-to-end anastomosis. However, postoperative stricture is observed often and becomes increasingly more difficult to dilate. The 2-stage urethroplasty and the patch graft are the most popular techniques today. i-s However, in addition to the 2 hospitalizations that the 2-stage procedures require, they are difficult to perform if the stricture is high in the prostatic urethra. In addition, strictures of the new proximal meatus often require 1 or more revisions, resulting in a 3 or 4-stage urethroplasty. In 1950 Badenoch published results of a pull-through urethroplasty by intraprostatic intussusception of the mobilized anterior urethra.
THE JOURNAL OF UROLOGY
Copyright © 1977 by The Williams & Wilkins Co.
DIRECT URETHRA-BLADDER NECK ANASTOMOSIS IN THE SURGICAL CORRECTION OF POSTERIOR URETHRAL STRICTURES NHIEP TANG* From the Department of Urology, Memorial Medical Center, Savannah, Georgia
ABSTRACT
A direct anastomosis of the urethra and bladder neck is suggested for posterior urethral strictures, especially high lesions. The technique is described, and its advantages and complications are discussed. Strictures of the posterior urethra pose a difficult therapeutic problem, which many have tried to solve with varying degrees of success. A periurethral approximation suture over a stent catheter after a scar excision often results in a recurring stricture. Partial pubectomy or pubic symphysiotomy offers a better approach to the posterior urethra for scar removal and a technically satisfying end-to-end anastomosis. However, postoperative stricture is observed often and becomes increasingly more difficult to dilate. The 2-stage urethroplasty and the patch graft are the most popular techniques today. i-s However, in addition to the 2 hospitalizations that the 2-stage procedures require, they are difficult to perform if the stricture is high in the prostatic urethra. In addition, strictures of the new proximal meatus often require 1 or more revisions, resulting in a 3 or 4-stage urethroplasty. In 1950 Badenoch published results of a pull-through urethroplasty by intraprostatic intussusception of the mobilized anterior urethra.
