Treatment of Obliterative Post-Traumatic Posterior Urethral Stenosis in Males When First Urethroplasty Has Failed
This protocol addresses male patients with obliterative post-traumatic posterior urethral stenosis in whom an initial urethroplasty has not achieved a durable result. Complete obliteration of the posterior urethra following trauma presents a distinct surgical challenge that requires a specific management pathway.
Clinical scenario: Male patient with obliterative post-traumatic posterior urethral stenosis. For this type of complete obliteration, endoscopic treatment is not appropriate — the anatomy mandates an open surgical approach, specifically progressive perineal excision and primary anastomosis (EPA).
Treatment direction: For motivated patients unwilling to accept palliative alternatives, the structured pathway involves a repeat open urethroplasty procedure after the first has failed. The full surgical approach, patient selection criteria, and procedural sequence are detailed in the complete protocol.
References
- Do not perform endoscopic treatment for an obliterative stenosis.
- Perform progressive perineal excision and primary anastomosis (EPA) for obliterative stenosis.
- Perform another urethroplasty after 1st failed urethroplasty in motivated patients not willing to accept palliative endoluminal treatments or urinary diversion.