Ramón Virasoro1,2, Jack M Zuckerman3, Kurt A McCammon3, Jessica M DeLong3, Jeremy B Tonkin3, Leandro Capiel4, Agustín R Rovegno4, Gabriel Favre5, Carlos R Giudice5, Ehab A Eltahawy6, Uri Gur7, Gerald H Jordan3. 1. Eastern Virginia Medical School, Norfolk, VA, USA. viravira@yahoo.com. 2. Department of Urology, Eastern Virginia Medical School, 225 Clearfield Avenue, Virginia Beach, VA, 23462, USA. viravira@yahoo.com. 3. Eastern Virginia Medical School, Norfolk, VA, USA. 4. Centro de Educación Médica e Investigaciones Clínicas "Dr. Norberto Quirno" (CEMIC), Buenos Aires, Argentina. 5. Hospital Italiano, Buenos Aires, Argentina. 6. University of Arkansas for Medical Sciences, Arkansas, AR, USA. 7. Meir Medical Center, Kfar Sava, Israel.
Abstract
OBJECTIVE: To present mid-term outcomes from an international, multi-institutional cohort of patients undergoing vessel-sparing excision and primary anastomosis urethroplasty for the reconstruction of the anterior urethra. MATERIALS AND METHODS: From June 2003 to December 2011, 68 patients underwent vessel-sparing anterior urethral reconstruction at five different international institutions using the vessel-sparing technique described by Jordan et al. (J Urol 177(5):1799-1802, 2007). RESULTS: Patients' age range was from 3 to 82 years (mean 51.2). Stricture length ranged from 1 to 3 cm (mean 1.78). After a mean follow-up of 17.6 months, 95.6 % of patients had a widely patent urethral lumen. Three patients failed the procedure, requiring either direct vision internal urethrotomy or urethral dilation, after which all were free of symptoms and did not require further instrumentation. Complications were minimal and as expected following open urethroplasty. CONCLUSION: Preservation of blood supply is a noble pursuit in surgery; however, it can be technically difficult and often requires more time and effort. This vessel-sparing technique for anterior urethral reconstruction is reproducible and appears to be reliable in this international cohort. Larger studies and longer follow-up are needed to support these encouraging results.
OBJECTIVE: To present mid-term outcomes from an international, multi-institutional cohort of patients undergoing vessel-sparing excision and primary anastomosis urethroplasty for the reconstruction of the anterior urethra. MATERIALS AND METHODS: From June 2003 to December 2011, 68 patients underwent vessel-sparing anterior urethral reconstruction at five different international institutions using the vessel-sparing technique described by Jordan et al. (J Urol 177(5):1799-1802, 2007). RESULTS:Patients' age range was from 3 to 82 years (mean 51.2). Stricture length ranged from 1 to 3 cm (mean 1.78). After a mean follow-up of 17.6 months, 95.6 % of patients had a widely patent urethral lumen. Three patients failed the procedure, requiring either direct vision internal urethrotomy or urethral dilation, after which all were free of symptoms and did not require further instrumentation. Complications were minimal and as expected following open urethroplasty. CONCLUSION: Preservation of blood supply is a noble pursuit in surgery; however, it can be technically difficult and often requires more time and effort. This vessel-sparing technique for anterior urethral reconstruction is reproducible and appears to be reliable in this international cohort. Larger studies and longer follow-up are needed to support these encouraging results.
Entities:
Keywords:
Excision and primary anastomosis; Urethral stricture; Vessel sparing
Authors: Sarah D Blaschko; Melissa T Sanford; Nadya M Cinman; Jack W McAninch; Benjamin N Breyer Journal: BJU Int Date: 2013-03-04 Impact factor: 5.588
Authors: Vladimir Beloborodov; Vladimir Vorobev; Alexey Kalyagin; Igor Seminskiy; Bator Sharakshinov; Sergei Popov; Olga Baklanova Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-04-06 Impact factor: 1.195