One approach three techniques: The ventral approach to the bulbar urethra in a high-volume UK tertiary referral centre
BAUS ePoster online library. Itam S. 11/10/20; 304174; P6-9
Sarah Itam
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One approach three techniques: The ventral approach to the bulbar urethra in a high-volume UK tertiary referral centre
Itam S1, Anderson P1
1Russells Hall Hospital, Dudley, United Kingdom
Introduction and objectives
Urethroplasty offers the best chance of long term benefit for patients presenting with urethral strictures. The aim of this study was to review the surgical outcomes of the ventral approach to substitution urethroplasty in a high volume tertiary centre.
Method
A prospective database of all men undergoing single stage penobulbar, full-length and bulbar urethroplasty between Jan 2013 and December 2016 was reviewed. Preoperatively men had a flexible urethroscopy and where indicated ascending/descending urethrogram studies. All operations were performed by a single surgeon. The urethra was opened ventrally in all cases- a graft was either placed as a ventral onlay, or a dorsal inlay, or a combination of the two in the case of very tight strictures. Post-operatively men received outpatient assessment which included a flexible urethroscopy at 24months.
Results
143 patients had a graft augmentation urethroplasty with a mean age of 47. The mean length of follow-up was 27.3months. 83 men had a ventral onlay urethroplasty, 43 men had a dorsal inlay, 17 men had a combination with both a ventral onlay graft and dorsal inlay. At 2 year follow-up 10 patients had graft narrowing, but only 2 patients required intervention with a total of 3 procedures.
Conclusion
The ventral approach to the urethra allows for 3 techniques with no significant difference in success rates. Freedom from intervention at 2 years was 98% with only 2 patients requiring further surgery. The ventral approach offers excellent outcomes for management of bulbar/penobulbar strictures whilst avoiding full urethral mobilisation.
Itam S1, Anderson P1
1Russells Hall Hospital, Dudley, United Kingdom
Introduction and objectives
Urethroplasty offers the best chance of long term benefit for patients presenting with urethral strictures. The aim of this study was to review the surgical outcomes of the ventral approach to substitution urethroplasty in a high volume tertiary centre.
Method
A prospective database of all men undergoing single stage penobulbar, full-length and bulbar urethroplasty between Jan 2013 and December 2016 was reviewed. Preoperatively men had a flexible urethroscopy and where indicated ascending/descending urethrogram studies. All operations were performed by a single surgeon. The urethra was opened ventrally in all cases- a graft was either placed as a ventral onlay, or a dorsal inlay, or a combination of the two in the case of very tight strictures. Post-operatively men received outpatient assessment which included a flexible urethroscopy at 24months.
Results
143 patients had a graft augmentation urethroplasty with a mean age of 47. The mean length of follow-up was 27.3months. 83 men had a ventral onlay urethroplasty, 43 men had a dorsal inlay, 17 men had a combination with both a ventral onlay graft and dorsal inlay. At 2 year follow-up 10 patients had graft narrowing, but only 2 patients required intervention with a total of 3 procedures.
Conclusion
The ventral approach to the urethra allows for 3 techniques with no significant difference in success rates. Freedom from intervention at 2 years was 98% with only 2 patients requiring further surgery. The ventral approach offers excellent outcomes for management of bulbar/penobulbar strictures whilst avoiding full urethral mobilisation.
One approach three techniques: The ventral approach to the bulbar urethra in a high-volume UK tertiary referral centre
Itam S1, Anderson P1
1Russells Hall Hospital, Dudley, United Kingdom
Introduction and objectives
Urethroplasty offers the best chance of long term benefit for patients presenting with urethral strictures. The aim of this study was to review the surgical outcomes of the ventral approach to substitution urethroplasty in a high volume tertiary centre.
Method
A prospective database of all men undergoing single stage penobulbar, full-length and bulbar urethroplasty between Jan 2013 and December 2016 was reviewed. Preoperatively men had a flexible urethroscopy and where indicated ascending/descending urethrogram studies. All operations were performed by a single surgeon. The urethra was opened ventrally in all cases- a graft was either placed as a ventral onlay, or a dorsal inlay, or a combination of the two in the case of very tight strictures. Post-operatively men received outpatient assessment which included a flexible urethroscopy at 24months.
Results
143 patients had a graft augmentation urethroplasty with a mean age of 47. The mean length of follow-up was 27.3months. 83 men had a ventral onlay urethroplasty, 43 men had a dorsal inlay, 17 men had a combination with both a ventral onlay graft and dorsal inlay. At 2 year follow-up 10 patients had graft narrowing, but only 2 patients required intervention with a total of 3 procedures.
Conclusion
The ventral approach to the urethra allows for 3 techniques with no significant difference in success rates. Freedom from intervention at 2 years was 98% with only 2 patients requiring further surgery. The ventral approach offers excellent outcomes for management of bulbar/penobulbar strictures whilst avoiding full urethral mobilisation.
Itam S1, Anderson P1
1Russells Hall Hospital, Dudley, United Kingdom
Introduction and objectives
Urethroplasty offers the best chance of long term benefit for patients presenting with urethral strictures. The aim of this study was to review the surgical outcomes of the ventral approach to substitution urethroplasty in a high volume tertiary centre.
Method
A prospective database of all men undergoing single stage penobulbar, full-length and bulbar urethroplasty between Jan 2013 and December 2016 was reviewed. Preoperatively men had a flexible urethroscopy and where indicated ascending/descending urethrogram studies. All operations were performed by a single surgeon. The urethra was opened ventrally in all cases- a graft was either placed as a ventral onlay, or a dorsal inlay, or a combination of the two in the case of very tight strictures. Post-operatively men received outpatient assessment which included a flexible urethroscopy at 24months.
Results
143 patients had a graft augmentation urethroplasty with a mean age of 47. The mean length of follow-up was 27.3months. 83 men had a ventral onlay urethroplasty, 43 men had a dorsal inlay, 17 men had a combination with both a ventral onlay graft and dorsal inlay. At 2 year follow-up 10 patients had graft narrowing, but only 2 patients required intervention with a total of 3 procedures.
Conclusion
The ventral approach to the urethra allows for 3 techniques with no significant difference in success rates. Freedom from intervention at 2 years was 98% with only 2 patients requiring further surgery. The ventral approach offers excellent outcomes for management of bulbar/penobulbar strictures whilst avoiding full urethral mobilisation.
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