Management of complicated posterior urethral stricture is challenging. Modified transperineal anastomotic urethroplasty (TAU) with bulbocavernosus flap interposition and human fibrin sealant provides another treatment option. We aimed to evaluate whether this technique could improve the success rate in the complicated posterior urethral stricture reconstruction in this study.
Between 2016 and 2019, 48 patients underwent either conventional or modified TAU. The criteria for success included both the absence of clinical symptoms and no need for further surgical intervention during follow-up.
Twelve patients underwent the modified TAU (group A) using bulbocavernosus flap interposition and human fibrin sealant. Thirty-six patients underwent the traditional end-to-end anastomotic urethroplasty (group B). Follow-up was 24.3-57.2 months. The patients in group A had a higher surgery success rate compared to the patients in group B (91.7 vs. 63.9%, P=0.067), with a quasi-significant result. Besides, no postoperative complications were observed in group A, while two individuals in group B had urinary incontinence, but the difference was not significant (0 vs. 5.6%, P=0.404).
Based on the preliminary results, modified TAU with bulbocavernosus flap interposition and human fibrin sealant is a safe and feasible technique for complicated posterior urethral stricture reconstruction.
International journal of surgery (London, England). 2023 Nov 17 [Epub ahead of print]
Menghua Wang, Liang Zhou, Banghua Liao, Donghui Ye, Yucheng Ma, Zhongyu Jian, Chi Yuan, Xi Jin, Hong Li, Kunjie Wang
Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China., Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.