Non-Transecting Bulbar Urethroplasty

Excision and primary anastomosis (EPA) is a standardized, repeatable procedure with an expected long-term success rate of 90–98.6% [1]. However, a full thickness transection of the corpus spongiosum, and the dual urethral blood supply within it, is unnecessary for some cases. Recent discussions in the reconstructive urological community have sparked a debate on the optimal management of bulbar urethral strictures, particularly concerning whether to transect the bulbar urethra or not in non-traumatic cases. Therefore, Mundy et al. (2015) developed a modified technique of non-transecting anastomotic bulbar urethroplasty. In this technique, a dorsal approach is used and the stricturotomy is carried out through the thinnest part of the spongiosum, therefore there is limited vascular compromise to the urethra [2]. This technique aims to achieve similar success rates as transecting EPA while avoiding the potential morbidity associated with dividing the corpus spongiosum in non-traumatic bulbar strictures.