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Purpose <p>To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.</p> Materials and methods <p>The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile–scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o’clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.</p> Results <p>The mean patient age was 46.7 years (range 27–64) and the median urethral stricture length was 5.1&#xa0;cm. The urethral catheter was removed 4 weeks postoperatively. The median follow-up duration was 13.6 months (4–32). Urinary flow remained unobstructed in 22 patients (91.7%), with an average maximum flow rate of 24.5&#xa0;ml/s (15.3–36.2). Urethral stricture recurred post-surgery in two patients, one of whom underwent successful repair with the same surgical procedure while the other achieved successful voiding after urethrotomy.</p> Conclusions <p>Urethral suspension-assisted urethral anastomosis is an effective treatment for complex long-segment posterior urethral stricture. This technique allows for optimal exposure of the proximal urethral mucosa, reduces the distance between the proximal and distal urethra, simplifies surgical procedures, enables tension-free anastomosis between the proximal and distal urethra, and has a high success rate.</p>

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Efficacy of urethral suspension-assisted urethral anastomosis as a treatment for complex long-segment posterior urethral stricture

  • 期刊论文

  • 发表日期：

    2025年1月17日

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  • Ying Wang,
  • Meng Liu,
  • Chongrui Jin,
  • Lujie Song,
  • Ranxing Yang,
  • Qiang Fu

摘要

Purpose

To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.

Materials and methods

The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile–scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o’clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.

Results

The mean patient age was 46.7 years (range 27–64) and the median urethral stricture length was 5.1 cm. The urethral catheter was removed 4 weeks postoperatively. The median follow-up duration was 13.6 months (4–32). Urinary flow remained unobstructed in 22 patients (91.7%), with an average maximum flow rate of 24.5 ml/s (15.3–36.2). Urethral stricture recurred post-surgery in two patients, one of whom underwent successful repair with the same surgical procedure while the other achieved successful voiding after urethrotomy.

Conclusions

Urethral suspension-assisted urethral anastomosis is an effective treatment for complex long-segment posterior urethral stricture. This technique allows for optimal exposure of the proximal urethral mucosa, reduces the distance between the proximal and distal urethra, simplifies surgical procedures, enables tension-free anastomosis between the proximal and distal urethra, and has a high success rate.