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Introduction: Excision and primary anastomosis (EPA) has been the gold standard procedure for definitively managing short bulbar urethral strictures. A non-transecting approach was developed to help preserve proximal blood supply of the urethra. The previously described technique involves a dorsal urethrotomy and excision of the stricture without disrupting the anterior spongiosum. We describe a novel approach by performing a ventral urethrotomy leaving the posterior spongiosum intact. By not requiring urethral rotation, we believe this technique is simpler and does not compromise outcomes. Methods: Retrospective chart review was performed on 8 consecutive patients from April 2019 to February 2021 who underwent non-transecting EPA with ventral urethrotomy for short bulbar urethral strictures. We reviewed demographics and when available pre and postoperative data points including uroflow, post-void residuals, SHIM and AUA scores. Results: All 8 patients underwent the aforementioned procedure. Average age was 48.6 years, and average stricture length was 1.375 cm. All 8 patients underwent postoperative voiding cystourethrogram at 2 weeks which confirmed no contrast extravasation and no residual stricture. We had a stricture free rate of 100% (8/8 cases) with median follow-up time of 4 months (range 0-14 months). Average increase in Q-max was 14.2 mL/s. Conclusion: Our case series demonstrates that non-transecting EPA with ventral urethrotomy is a safe and effective alternative to dorsal urethrotomy for the management of short bulbar urethral strictures with the added benefit of requiring less complexity


The 95th Annual Meeting of the North Central Section of the AUA, Chicago, IL, October 6-9, 2021.

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