Techniques and outcomes of end primary anastomotic urethroplasty in management of

urethral stricture: a descriptive study

Andhika Novianda1, Ramlan Nasution2
1
Department of Urology, Faculty of Medicine, Universitas Indonesia–H. Adam Malik
Hospital, Medan, Indonesia
2
Department of Urology, Faculty of Medicine, Universitas Sumatera Utara–H. Adam Malik
Hospital, Medan, Indonesia

Abstract
Introduction
Urethral stricture is a long-known disease and could be either congenital or acquired origin.
However, the management of urethral stricture has vary outcomes. One of the best result in
short strictures is excision and re-anastomosis. Here, we aimed to describe our practice for the
success rate of end primary anastomotic (EPA) urethroplasty in urethral stricture patients.
Materials and Methods
We conduct a descriptive study for urethral stricture patients underwent EPA in H. Adam Malik
General Hospital from 2014 to 2018. The patients were divided into trauma and non-trauma
groups. Routine investigation was performed, including history taking, physical evaluation,
dynamic retrograde, and voiding cystourethrogram. All of the patients underwent EPA
urethroplasty by a single operating surgeon. Post-operative consultation and
cystourethrography were done to evaluate the outcome of the procedure.
Results
A total of nine patients was included in this study, averaging 34.2-year-old. Trauma is the
leading cause in seven patients (77.8%), and the other two were idiopathic in the non-trauma
group. Pars membranosa is the most commonly affected with seven cases followed by pars
bulbosa. Eight patients have successful result while the other one has a recurrence and six
months later, the second procedure of EPA was performed.
Conclusion
The most common cause for urethral stricture is trauma, and excision followed by anastomosis
technique has provided a great result with a high success rate. However, recurrence could still
be happened beside the high success rate.
Keywords
End primary anastomotic urethroplasty, Short urethral stricture, Traumatic urethral stricture.