This protocol applies to male patients with a confirmed non-obliterative vesico-urethral anastomosis stricture (VUAS) — a narrowing at the anastomosis that preserves at least partial luminal patency. The male sex and the non-obliterative character of the stricture are the defining features of this scenario.
The protocol centres on surgical revision of the vesico-urethral anastomosis. Two operative approaches are defined; selection between them is determined by the patient's pre-operative status.
The complete regimen — including full approach-selection criteria, surgical detail, and follow-up — is available in the protocol below.
Perform visually controlled dilatation or direct vision internal urethrotomy (DVIU) as 1st line-treatment for a non-obliterative vesico-urethral anastomosis stricture (VUAS) or radiation-induced bulbomembranous strictures (BMS).
Perform ReDo vesico-urethral anastomosis (VUA) in non-irradiated patients and irradiated patients with adequate bladder function with obliterative vesico-urethral anastomosis stricture or vesico-urethral anastomosis stricture refractory to endoluminal treatment.
Offer ReDo VUA by retropubic approach if the patient is pre-operatively continent.
View source ↗