Ramón Virasoro1, Jessica M DeLong2. 1. Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health, 225 Clearfield Ave, Virginia Beach, VA, 23462, USA. VirasoR@evms.edu. 2. Eastern Virginia Medical School, Devine-Jordan Center for Reconstructive Surgery and Pelvic Health, 225 Clearfield Ave, Virginia Beach, VA, 23462, USA.
Abstract
PURPOSE: To present current evidence supporting the vessel sparing technique to reconstruct bulbar urethral strictures via primary anastomosis. METHODS: English literature review of presented series of transecting and non-transecting bulbar urethroplasty from 2000 to 2018. RESULTS: Since its introduction in 2007, vessel-sparing excision and primary anastomosis (VS-EPA) has been utilized in multiple centers across the world. Success rates range from 90 to 98%, comparable to traditional transecting EPA. Complication rates and erectile function outcomes are similar or better in VS-EPA, according to recent publications. CONCLUSIONS: Non-transection excision and primary anastomosis is a well-tolerated, highly successful reconstructive option for short bulbar urethral strictures in appropriately selected patients. Results are comparable with traditional transecting anastomosis and mid-term multinational follow-up has proven efficacy and safety of the technique. Further well-designed multi-institutional studies are necessary to determine superiority to traditional EPA in terms of surgical outcomes and erectile function preservation.
PURPOSE: To present current evidence supporting the vessel sparing technique to reconstruct bulbar urethral strictures via primary anastomosis. METHODS: English literature review of presented series of transecting and non-transecting bulbar urethroplasty from 2000 to 2018. RESULTS: Since its introduction in 2007, vessel-sparing excision and primary anastomosis (VS-EPA) has been utilized in multiple centers across the world. Success rates range from 90 to 98%, comparable to traditional transecting EPA. Complication rates and erectile function outcomes are similar or better in VS-EPA, according to recent publications. CONCLUSIONS: Non-transection excision and primary anastomosis is a well-tolerated, highly successful reconstructive option for short bulbar urethral strictures in appropriately selected patients. Results are comparable with traditional transecting anastomosis and mid-term multinational follow-up has proven efficacy and safety of the technique. Further well-designed multi-institutional studies are necessary to determine superiority to traditional EPA in terms of surgical outcomes and erectile function preservation.
Authors: V Sceberras; E Attico; E Bianchi; G Galaverni; M Melonari; F Corradini; M Fantacci; A Ribbene; L Losi; S Balò; M Lazzeri; C Trombetta; M Rizzo; R Manfredini; G Barbagli; G Pellegrini Journal: World J Urol Date: 2019-07-09 Impact factor: 4.226
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