Transperineal Bulboprostatic Anastomosis in Patients With Simple Traumatic Posterior Urethral Strictures: A Retrospective Study from a Referral Urethral Center
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Abstract
To evaluate the results of ancillary procedures for posterior urethroplasty and compare
them with the severity of urethral stricture.
A total of 301 patients (average age: 36 years) with posterior urethral strictures
due to pelvic fracture urethral distraction defects were included in the study. Delayed
transperineal bulboprostatic anastomosis was performed 6-24 months (mean 10 months)
after pelvic fracture urethral distraction defects. Simple perineal anastomosis: 103
(34.2%) patients (group 1); perineal anastomosis with separation of the corporeal
bodies: 89 (29.6%) patients (group 2); perineal anastomosis with inferior pubectomy:
95 (31.6%) patients (group 3); perineal anastomosis with rerouting of the urethra
around the corpora cavernosum: 14 (4.7%) patients (group 4). The clinical outcome
was considered a failure when any postoperative instrumentation was needed. The primary
outcome examined the total success rate of the procedures. The secondary outcome examined
the success rate of the procedures according to the ancillary surgical steps.
Of the 301 delayed transperineal bulboprostatic anastomosis procedures, 263 (87.4%)
were successful and 38 (12.6%) were unsuccessful. Simple perineal anastomosis without
ancillary procedures reflected an 89.3% success rate, perineal anastomosis with separation
of the corporeal body had an 86.5% success rate, perineal anastomosis with inferior
pubectomy had an 84.2% success rate, and perineal anastomosis with urethral rerouting
had an 85.7% success rate.
Corporal splitting, inferior pubectomy, and urethral rerouting are beneficial and
useful ancillary procedures in transperineal posterior urethroplasty to achieve tension-free
anastomosis.