POSTTRAUMATIC POSTERIOR URETHRAL STRICTURE REPAIR - ANATOMY, SURGICALAPPROACH AND LONG-TERM RESULTS

Purpose: We describe the anatomy, surgical approach and long-term resu lts of posterior urethral stricture repair. Materials and Methods: Bet ween 1975 and 1991, 86 patients underwent, surgery for posttraumatic p osterior urethral stricture. In 65 patients the urethral lesion was co rrected by 1-stage reconstructive surgery via the perineal approach. I n 21 patients the urethra was reconstructed with a 2-stage procedure. In an anatomical study the course of the urethra through the pelvic fl oor was investigated and the concomitant structures were dissected. Ac cording to the anatomy a perineal approach was used in 7 male adult ca davers. Results: Due to the optimized anastomotic technique urinary fl ow rates of more than 20 mi. per second could be achieved in 29 of all 42 patients followed. Only 6 of these patients had peak urinary flow rates of less than 15 mi. per second. No patient had any recurrent str ictures at the anastomotic site that would have required surgical revi sion. Conclusions: Our results suggest that adequate primary care and the perineal approach combined with an exact anastomosis technique are essential for successful treatment of posttraumatic strictures of the posterior urethra.