Treatment of Bulbar Urethral Stricture Not Amenable to Excision and Primary Anastomosis in Male Patients

This protocol covers male patients with a bulbar urethral stricture where excision and primary anastomosis (EPA) is not viable — specifically when the stricture length exceeds 2–3 cm, ruling out the standard short-segment repair.

Clinical Scenario

Male sex; bulbar urethral stricture not amenable to excision and primary anastomosis, with a stricture length greater than 2–3 cm. The anatomical extent of the narrowing places standard EPA outside the range of feasibility.

Treatment Approach (Partial)

Management in this setting involves free graft urethroplasty techniques. The specific procedure depends on stricture characteristics and prior surgical history — including whether a previous urethroplasty has been attempted. The complete selection algorithm and approach details are available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

Use free graft urethroplasty for bulbar strictures not amenable to excision and primary anastomosis (EPA).

Use oral mucosa free graft urethroplasty for ReDo urethroplasty in the case of a long stricture.

Use augmented anastomotic repair for bulbar strictures not amenable to EPA but with a short, nearly obliterative segment within the whole strictured segment.

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