Non-transecting bulbar urethroplasty is favored over transecting techniques

Purpose To present current evidence supporting the vessel sparing technique to reconstruct bulbar urethral strictures via primary anastomosis. Methods English literature review of presented series of transecting and non-transecting bulbar urethroplasty from 2000 to 2018. Results Since its introduction in 2007, vessel-sparing excision and primary anastomosis (VS-EPA) has been utilized in multiple centers across the world. Success rates range from 90 to 98%, comparable to traditional transecting EPA. Complication rates and erectile function outcomes are similar or better in VS-EPA, according to recent publications. Conclusions Non-transection excision and primary anastomosis is a well-tolerated, highly successful reconstructive option for short bulbar urethral strictures in appropriately selected patients. Results are comparable with traditional transecting anastomosis and mid-term multinational follow-up has proven efficacy and safety of the technique. Further well-designed multi-institutional studies are necessary to determine superiority to traditional EPA in terms of surgical outcomes and erectile function preservation.