Transperineal bulboprostatic anastomotic repair of pelvic fracture urethral distraction defect and role of proximal urethral mobilisation: A retrospective study in 76 patients

Objective: We present our experience with transperineal bulboprostatic anastomotic procedure and compare the results with age of patients, length of urethral stricture, effect of previous treatment and need for urethral mobilisation. Materials and Methods: We retrospectively reviewed the outcome of 76 patients who underwent perineal urethroplasty procedure for traumatic stricture in our institute. Perineal urethroplasty with full distal urethral mobilisation was done in 30 patients. In 46 patients, minimal distal bulbar urethral mobilization was done coupled with more extensive proximal mobilization and use of other techniques like corporal separation & inferior pubectomy. Age, length of stricture and urethral mobilisation required during reconstruction were documented. The clinical outcome was measured by patient’s symptomatic improvement and objective measurements like uroflowmetry and retrograde urethrogram. Result: Out of the total 76 cases that underwent transperineal urethroplasty procedure, 69 (90.78%) were successful. Perineal urethroplasty with full distal mobilisation procedure showed a success rate of 83.33%, perineal anastomosis with more extensive proximal urethral mobilisation had a success rate of 95.65%. Conclusion: The success rate of perineal urethroplasty with proximal urethral mobilisation procedure for posttraumatic stricture urethra is excellent and majority of the failures occur in prepubescent boys ,long urethral stricture, in those undergoing secondary repair and in those cases in which more distal urethral mobilisation done.