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. 2024 May 11;54(4):771-777.
doi: 10.55730/1300-0144.5848. eCollection 2024.

Ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty for bulbar urethral strictures: a single-center experience

Musab Ali Kutluhan  1 , Sait Aygün  1 , Selman Ünal  2 , Asım Özayar  1 , Emrah Okulu  1 , Kemal Ener  1 , Önder Kayigil  1
Affiliations

Ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty for bulbar urethral strictures: a single-center experience

Musab Ali Kutluhan et al. Turk J Med Sci. .

Abstract

Background/aim: This study describes ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty and presents the preliminary functional results of patients treated with this technique.

Materials and methods: Twenty-three patients who underwent vANTA urethroplasty were included in the study. Stricture location, stricture length, preoperative uroflowmetry parameters (maximum flow rate (Qmax) and mean flow rate (Qmean)), preoperative International Index of Erectile Function (IIEF)-5 scores, operation time, postoperative complications, length of hospital stay, and follow-up periods were recorded. The Qmax, Qmean, and IIEF-5 scores of the patients were recorded again in the second and twelfth postoperative months. Preoperative and postoperative Qmax values and IIEF-5 scores were compared. Kaplan-Meier survival analysis was performed to demonstrate recurrence-free survival.

Results: The mean age of the patients included in the study was 52.1 ± 16.9 years. Mean stricture length was 2.5 ± 0.5 cm. There was a statistically significant difference between preoperative and 2-month postoperative uroflowmetry Qmax values (6.9 (0.0-14.5) vs. 18.5 (5.5-41.5) mL/s; p < 0.001). There was no statistically significant difference in preoperative and 2-month postoperative IIEF-5 scores (p > 0.05). There was a statistically significant difference between preoperative and 1-year postoperative median Qmax values (7.2 (0.0-12.3) vs. 17.4 (11.2-24.3) mL/s; p = 0.001). There was no statistically significant difference between preoperative and 1-year postoperative IIEF-5 scores (p > 0.05). According to Kaplan-Meier recurrence-free survival analysis, the recurrence-free survival rate at 6 months was 95.7.

Conclusion: In cases of bulbar urethral strictures, vANTA urethroplasty is an effective treatment option with limited postoperative complications. Preserving the underlying corpus spongiosum is important to avoid impaired sexual function.

Keywords: Urethral stricture; quality of life; sexual function; urethroplasty; urinary function.

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Conflict of interest statement

Conflict of interest: All authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
a) Very tight section of the stricture is marked; b) mucosa is excised, preserving the underlying spongiosum; c) mucosa-to-mucosa anastomosis with 5/0 rapid Vicryl. White arrows show the tightest urethral segment.
Figure 2
Figure 2
a) The Stenon canal and buccal mucosal graft incision line are marked; b) placement of the ventral-onlay buccal mucosa graft. White arrows show the buccal mucosa graft that was harvested and placed on the urethra.
Figure 3
Figure 3
a) Preoperative retrograde urethrography; b) postoperative retrograde urethrography in week 3 of follow-up. Black arrows show the location of the urethral stricture.
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References

    1. Alwaal A, Blaschko SD, McAninch JW, Breyer BN. Epidemiology of urethral strictures. Translational Andrology and Urology. 3(2):209–213. doi: 10.3978/j.issn.2223-4683.2014.04.07. - DOI - PMC - PubMed
    1. Santucci R, Eisenberg L. Urethrotomy has a much lower success rate than previously reported. The Journal of Urology. 183(5):1859–1862. doi: 10.1016/j.juro.2010.01.020. - DOI - PubMed
    1. Barbagli G, Guazzoni G, Lazzeri M. One-stage bulbar urethroplasty: retrospective analysis of the results in 375 patients. European Urology. 53(4):828–833. doi: 10.1016/j.eururo.2008.01.041. - DOI - PubMed
    1. Barbagli G, Selli C, Tosto A, Palminteri E. Dorsal free graft urethroplasty. The Journal of Urology. 155(1):123–126. doi: 10.1016/S0022-5347(01)66566-2. - DOI - PubMed
    1. Morey AF, McAninch JW. When and how to use buccal mucosal grafts in adult bulbar urethroplasty. Urology. 48(2):194–198. doi: 10.1016/S0090-4295(96)00154-9. - DOI - PubMed

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