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
Sarah Itam
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)
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.
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.
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies