The Augmented Anastomotic Urethroplasty

Chapter
Part of the Current Clinical Urology book series (CCU)

Abstract

Primary anastomotic urethroplasty with complete stricture excision provides for the most successful outcome in bulbar urethral reconstruction. However, there are times when, following stricture excision and urethral spatulation, too much tension would be present for a primary anastomosis. The augmented anastomotic urethroplasty is a combination repair that incorporates the principles of excision and substitution urethroplasty. It is intended for bulbar strictures deemed too long for straightforward primary anastomosis, particularly those with a dense area of scarring and adjacent wider caliber stricture. With this technique, up to 2 or 3 cm of strictured urethra may be excised, followed by reapproximation of either the dorsal or ventral walls. The opposite urethral wall is then closed with an onlay graft. In this chapter, we discuss our graded approach to the management of bulbar strictures and our rationale for utilizing the augmented anastomotic repair and outline our surgical technique.

Keywords

Catheter Rubber 

Notes

Acknowledgements

The authors wish to thank Dr. George Webster, one of the authors of this chapter in the 1st edition, for his guidance, mentoring and friendship. We would also like to acknowledge his invaluable contributions to the art of urethral surgery

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of UrologyMedical College of WisconsinMilwaukeeUSA

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