Outcome of Augmented Versus Anastomotic Urethroplasty Comparison in Bulbar Stricture Urethra of 2–3 cm Length
Introduction: Stricture urethra, that is, fibrous narrowing of urethra is one of the challenging urethral conditions which occur
due to inflammation of urethra, trauma to urethra, or due to idiopathic cause. There are various methods of the treatment of
stricture urethra which depends on length, location, depth, and density. Because the bulbar urethra is relatively mobile, removal
of the narrowing of lesser size and re-join the ends over a catheter is called anastomotic urethroplasty. Longer, recurrent,
or complicated strictures need to be widened by cutting into the narrowed area and inserting a graft material is known as
Aim: This study aims to know outcome of augmented and anastomotic urethroplasty in strictures of 2–3 cm by retrospective
Materials and Methods: This was a retrospective study performed in 64 patients of bulbar urethral strictures equal or <3 cm
admitted to the department of urology. It is compare of success rate, complications, and patient satisfaction in two types of
urethroplasties augmented versus anastomotic. Patient’s basic demographic parameters, diagnostic investigations for the
urethral strictures, pre-operative uroflowmetry, surgical procedures, post-operative complications, and follow-up uroflowmetry
and cystoscopy findings were analyzed and compared.
Results: Most of the patients in the age groups of 31–40 and trauma is the leading cause of stricture. Anastomotic group
patients stayed more in the hospital. Augmented urethroplasty had very superior success rates (100%) than to the anastomotic
urethroplasty (84.6%). Complications were also more in anastomotic urethroplasty.
Conclusion: In this study augmented, urethroplasty is superior to anastomotic urethroplasty with fewer post-operative
urethra. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, editors. Campbell-
Walsh Urology. Amsterdam, Netherlands: Elsevier; 2016. p. 916-38.
2. Perez PR, Linares AM. Complications of the lower urinary tract secondary
to urethral stenosis. Acta Urol Esp 1996;20:786-93.
3. Matouschek E. Internal urethrotomy of urethral stricture under vision a
five-year report. Urol Res 1978;6:147-50.
4. Smith P, Dunn M, Dounis A. Sachse optical urethrotome in management
of urethral stricture in the male preliminary communication. J R Soc Med
5. Humby G. A one-stage operation for hypospadias repair. Br J
6. Joshi P, Kaya C, Kulkarni S. Approach to bulbar urethral strictures: Which
technique and when? Turk J Urol 2016;42:53-9.
7. Wein A, Kavoussi L, Partin A, Peters C. Campbell-Walsh Urology. 11th ed.
Amsterdam, Netherlands: Elsevier; 2015. p. 916-31.
8. Oguike TC, Onuora VC, Obarisiagbon E. The changing pattern of urethral
stricture disease in Midwestern Nigeria. J Biomed Sci 2006;5:50-4.
9. Beard DE, Goodyear WE. Urethral stricture: A pathological study. J Urol
10. Shadab M, Pankaj D, Muni S, Anand M, Ali MS. A study of types of
urethral stricture and their management. Int Surg J 2016;3:1906-10.
11. Webster GD, Koefoot RB, Sihelnik SA. Urethroplasty management in
100 cases of urethral stricture: A rationale for procedure selection. J Urol
12. Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H. Urethral stricture:
Etiology, investigation and treatments. Dtsch Arztebl Int 2013;110:220-6.
13. Pansadoro V, Emiliozzi P. Internal urethrotomy in the management of
anterior urethral strictures: Long-term followup. J Urol 1996;156:73-5.
14. Mohanty NK, Khetan M, Jha AK, Arora RP. Optical internal urethrotomy
under local anaesthesia. Indian J Urol 2000;17:28-30.
15. Gupta S, Roy S, Pal DK. Efficacy of oral steroids after optical internal
urethrotomy in reducing recurrence of urethral strictures. Turk J Urol
16. Bhargava S, Chapple CR. Buccal mucosal urethroplasty: Is it the new gold
standard? BJU Int 2004;93:1191-3.
17. Zimmerman WB, Santucci RA. Buccal mucosa urethroplasty for adult
urethral strictures. Indian J Urol 2011;27:364-70.
18. Micheli E, Ranieri A, Peracchia G, Lembo A. End-to-end urethroplasty:
Long-term results. BJU Int 2002;90:68-71.
19. Park SI, McAninch JW. Straddle injuries to the bulbar urethra: Management
and outcomes in 78 patients. J Urol 2004;171:722.
20. Koraitim MM. On the art of anastomotic posterior urethroplasty: A 27-year
experience. J Urol 2005;173:135-9.
21. Morey AF, McAninch JW. When and how to use buccal mucosal grafts in
adult bulbar urethroplasty. Urology 1996;48:194-8.
22. Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M.
Bulbar urethroplasty using buccal mucosa grafts placed on the ventral,
dorsal or lateral surface of the urethra: Are results affected by the surgical
technique? J Urol 2005;174:955-7.
23. Dubey D, Kumar A, Bansal P, Srivastava A, Kapoor R, Mandhani A, et al.
Substitution urethroplasty for anterior urethral strictures: A critical appraisal
of various techniques. BJU Int 2003;91:215-8.
24. Elliott SP, Metro MJ, McAninch JW. Long-term followup of the ventrally
placed buccal Mucosa onlay graft in bulbar urethral reconstruction. J Urol2003;169:1754-7.
25. Heinke T, Gerharz EW, Bonfig R, Riedmiller H. Ventral onlay urethroplasty
using buccal mucosa for Complex stricture repair. Urology 2003;61:1004-7.
26. Kane CJ, Tarman GJ, Summerton DJ, Buchmann CE, Ward JF, O’Reilly KJ,
et al. Multi-institutional experience with buccal Mucosa onlay urethroplasty
for bulbar urethral reconstruction. J Urol 2002;167:1314-7.
27. Kellner DS, Fracchia JA, Armenakas NA. Ventral onlaybuccal mucosal
grafts for anterior urethral strictures: Long-term followup. J Urol
28. Kulkarni S, Barbagli G, Kirpekar D, Mirri F, Lazzeri M. Lichen sclerosus of
the male genitalia and urethra: Surgical options and results in a multicenter
international experience with 215 patients. Eur Urol 2009;55:945-54.
29. Sawant AS, Savalia AJ. Audit of anterior urethroplasty techniques. J Clin
Diagn Res 2018;12:PC17-21