Introduction

The non-transecting approach to bulbar urethroplasty was popularised by Jordan et al and Andrich et al and is being used increasingly. We reviewed our experience with this procedure.

Patients and Methods

Between 2009 and 2015, 125 men have undergone “non-transecting approaches” to their bulbar stricture; idiopathic strictures (n=112), iatrogenic (n=5), urethral trauma (n=5), post-radical prostatectomy (n=5), post-TURP (n=3) . 58 had a non-transecting mucosal anastomotic repair, 48 a non-transecting augmented urethroplasty using buccal graft and 19 underwent a Heineke-Mikulicz-type stricturoplasty alone.
All patients underwent clinical assessment, flow rate studies and urethrograms prospectively.

Results

Clinically, 116 patient (92.8%) were happy with the result of their surgery, 2 were unhappy (but had normal flow rates) and there were 4 failures. 3 were lost to follow-up. Mean post-operative peak flow rate was 34.9mlss in 102 patients. 7 patients had flow rates less than 15mlss, including the 4 failures. 3 were not assessable due to low voided volumes, 13 refused flow rate and 3 were lost to follow-up. On urethrogram, 120 were normal, 1 had a slightly reduced calibre but had normal flow rate, there were 4 recurrent strictures and 9 refused or were lost to follow-up.
Overall 118 of 122 (96%) were a success by radiology and flow rate as well as subjectively.

Conclusion

The non-transecting approach to bulbar urethroplasty gives results that are at least as good as previously reported for excision and anastomosis or augmented anastomotic or dorsal patch urethroplasty. The increasingly widespread use of this procedure is therefore entirely justified.