Document Detail

The augmented nontransected anastomotic urethroplasty for the treatment of bulbar urethral strictures.
MedLine Citation:
PMID:  22309783     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The augmented anastomotic urethroplasty (AAU) combines resection of a urethral stricture and an onlay graft. The augmented nontransected anastomotic urethroplasty (ANTA) is a modification of the AAU and involves complete stricture excision without transecting the spongiosum.
MATERIALS AND METHODS: This is a retrospective cohort study comparing ANTA with dorsal onlay buccal grafting (DOBG) for bulbar urethral strictures. Medical records between 2005 and 2010 were reviewed. A cross-sectional questionnaire was used to assess long-term outcomes. Medians and interquartile ranges are reported.
RESULTS: Forty-four men (23 DOBG, 21 ANTA) with a median follow-up of 2.3 years (range 1.2-3.8) were identified. There were no significant differences between ANTA patients and DOBG patients in terms of age, previous treatment, stricture location, or postoperative follow-up. There was no significant difference between groups in the use of bilateral buccal grafts (P = .416); median buccal length harvested was significantly less in the ANTA group (4.5 cm [range 4.0-5.0]) vs the DOBG group (5.0 cm [range 5.0-8.0], P = .047). Response rate to the cross-sectional survey was 59%. Five patients reported postoperative donor site complications, and there were no significant differences between the ANTA and DOBG groups. Overall success was 93% and not statistically different between groups (log rank test, P = .548). One ANTA patient and 2 DOBG patients required posturethroplasty treatment.
CONCLUSIONS: The ANTA has results similar to DOBG and appears to be a viable option in the treatment of bulbar urethral strictures. This technique allows the surgeon to avoid urethral transection, to reconfigure the width of the urethral plate, and to use a smaller buccal graft.
Blayne K Welk; Ron T Kodama
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Publication Detail:
Type:  Journal Article     Date:  2012-02-04
Journal Detail:
Title:  Urology     Volume:  79     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-03     Completed Date:  2012-07-02     Revised Date:  2012-11-27    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  917-21     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada.
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MeSH Terms
Anastomosis, Surgical
Middle Aged
Mouth Mucosa / transplantation
Retrospective Studies
Urethra / surgery*
Urethral Stricture / surgery*
Urologic Surgical Procedures, Male / methods*
Comment In:
Urology. 2012 Oct;80(4):959; author reply 959-60   [PMID:  23021677 ]
J Urol. 2012 Oct;188(4):1210-1   [PMID:  22971379 ]

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