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01-07-2017 | Minimally Invasive Surgery (T Guzzo, Section Editor)

Tissue Preservation Techniques at the Time of Urethroplasty for Urethral Stricture Disease

Authors: Robert Caleb Kovell, Alexander J. Skokan

Published in: Current Urology Reports | Issue 7/2017

Abstract

Reconstructive surgery for urethral stricture disease seeks to re-establish long-lasting urethral patency while minimizing associated adverse effects. In recent years, genitourinary reconstructive surgeons have developed and refined a number of techniques that seek to decrease the impact of urethroplasty on local tissues including blood supply and innervation. This review presents an outline of recent advances in urethral reconstructive techniques that seek to minimize surgical impact, including tissue preservation, tissue engineering, and minimally invasive approaches and reviews the current state of the literature related to these techniques.

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Virasora R, Zuckerman JM, McCammon KA, et al. International multi-institutional experience with the vessel-sparing technique to reconstruct the proximal bulbar urethra: mid-term results. World J Urol. 2015;33(12):2153–7.CrossRef

Gomez RG, Campos RA, Velarde LG. Reconstruction of pelvic fracture urethral injuries with sparing of the bulbar arteries. Urology. 2016;88:207–12.CrossRefPubMed

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•• Andrich DE, Mundy AR. Non-transecting anastomotic bulbar urethoplasty: a preliminary report. BJU Int. 2012;109(7):1090–4. Building upon an already successful intervention for some urethral strictures, this article describes a novel technique aimed to improve outcomes in a specific patient cohort at potential risk for urethroplasty failure. While the follow-up is short-term and the patient population is small, it suggests noninferiority of the non-transectig anastomotic repair when compared to the current standard, and it proposes that this technique merits further rigorous investigation. CrossRefPubMed

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• Fredrick A, Erickson BA, Stensland KS, et al. Functional effects of bulbospongiosus muscle sparing on ejaculatory function and post-void dribbling after bulbar urethroplasty. J Urol. 2017;197(3 pt 1):738–43. This study evaluates target symptomatic outcomes of the bulbospongiosus-sparing technique in a well thought-out manner. Its relatively small cohort highlights the need for longitudinal and long-term follow-up, as well as the potential benefit of large-scale multi-institutional studies to investigate these and other important questions in the field of urethral reconstruction. CrossRefPubMed

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Kulkarni SB, Barbagli G, Joshi PM, et al. Laparoscopic omentoplasty to support anastomotic urethroplasty in complex and redo pelvic fracture urethral defects. Urology. 2015;85(5):1200–5.CrossRefPubMed

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Title: Tissue Preservation Techniques at the Time of Urethroplasty for Urethral Stricture Disease
Authors: Robert Caleb Kovell
Alexander J. Skokan
Publication date: 01-07-2017
Publisher: Springer US
Published in: Current Urology Reports / Issue 7/2017
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-017-0697-4

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Tissue Preservation Techniques at the Time of Urethroplasty for Urethral Stricture Disease

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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