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The advantages of the ventral approach to bulbar urethroplasty.

Palminteri E, Berdondini E, Di Pierro GB - Arab J Urol (2013)

Bottom Line: Currently, the superiority of one surgical technique over another has not yet been clearly defined.Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications.The graft urethroplasty using the ventral approach fulfils these requirements.

View Article: PubMed Central - PubMed

Affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.

ABSTRACT

Background: Several surgical techniques have been described for the treatment of bulbar urethral strictures, and the main goal of modern surgery is to reduce morbidity and obtain the best outcome with the fewest complications. Currently, the superiority of one surgical technique over another has not yet been clearly defined.

Methods: We analysed the historical background, advantages and disadvantages of several urethral approaches and graft placements, with the aim of focusing on the advantages of the ventral approach.

Conclusions: For short bulbar strictures (<2 cm) the traditionally advocated method is excision and end-to-end anastomosis, whilst for longer strictures, in the last decade, the patch graft urethroplasty has been used, with buccal mucosa advocated as the standard material of substitution. Our analysis showed that the approach (dorsal vs. ventral) to the bulbar urethral lumen and the location of the patch (dorsal vs. ventral) are contentious issues. Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications. The graft urethroplasty using the ventral approach fulfils these requirements.

No MeSH data available.


Related in: MedlinePlus

Dorsal grafting by the ventral urethrotomy approach.
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f0010: Dorsal grafting by the ventral urethrotomy approach.

Mentions: The ventral approach allows dorsal or ventral or dorsal plus ventral grafting. In 1999, for hypospadias surgery, Hayes and Malone [15] suggested a development of the longitudinal incision of the urethral plate described by Snodgrass, by laying an oral mucosal graft into the incised urethral plate. After merging these concepts, in 2001 Asopa et al. [16] popularised a similar technique suitable for the repair of both penile and bulbar strictures, i.e., dorsal grafting by the ventral urethrotomy approach (Fig. 2).


The advantages of the ventral approach to bulbar urethroplasty.

Palminteri E, Berdondini E, Di Pierro GB - Arab J Urol (2013)

Dorsal grafting by the ventral urethrotomy approach.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4442972&req=5

f0010: Dorsal grafting by the ventral urethrotomy approach.
Mentions: The ventral approach allows dorsal or ventral or dorsal plus ventral grafting. In 1999, for hypospadias surgery, Hayes and Malone [15] suggested a development of the longitudinal incision of the urethral plate described by Snodgrass, by laying an oral mucosal graft into the incised urethral plate. After merging these concepts, in 2001 Asopa et al. [16] popularised a similar technique suitable for the repair of both penile and bulbar strictures, i.e., dorsal grafting by the ventral urethrotomy approach (Fig. 2).

Bottom Line: Currently, the superiority of one surgical technique over another has not yet been clearly defined.Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications.The graft urethroplasty using the ventral approach fulfils these requirements.

View Article: PubMed Central - PubMed

Affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.

ABSTRACT

Background: Several surgical techniques have been described for the treatment of bulbar urethral strictures, and the main goal of modern surgery is to reduce morbidity and obtain the best outcome with the fewest complications. Currently, the superiority of one surgical technique over another has not yet been clearly defined.

Methods: We analysed the historical background, advantages and disadvantages of several urethral approaches and graft placements, with the aim of focusing on the advantages of the ventral approach.

Conclusions: For short bulbar strictures (<2 cm) the traditionally advocated method is excision and end-to-end anastomosis, whilst for longer strictures, in the last decade, the patch graft urethroplasty has been used, with buccal mucosa advocated as the standard material of substitution. Our analysis showed that the approach (dorsal vs. ventral) to the bulbar urethral lumen and the location of the patch (dorsal vs. ventral) are contentious issues. Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications. The graft urethroplasty using the ventral approach fulfils these requirements.

No MeSH data available.


Related in: MedlinePlus