This protocol addresses a well-defined subset of male urethral stricture: a primary, single, short (< 2 cm), non-obliterative stricture at the bulbar urethra in a patient who is a candidate for urethroplasty. The specific anatomical characteristics and treatment eligibility of this presentation determine which intervention is most appropriate.

Clinical Scenario

The stricture is located in the bulbar urethra, is non-obliterative, and measures less than 2 cm in length — characteristics associated with the best patency outcomes following minimally invasive approaches. The patient has not previously been treated and is eligible for surgical reconstruction.

Surgical Approach

For this presentation, the recommended intervention is urethroplasty — surgical reconstruction of the bulbar urethra. The specific technique indicated in this setting involves a non-transecting approach; the full protocol details which option applies and under what conditions.

References

The best patency rates with DVIU/dilatation are reported among untreated patients with a single, short (max. 2 cm) bulbar stricture.
Perform DVIU/dilatation for a primary, single, short (< 2 cm) and non-obliterative stricture at the bulbar urethra.
Do not perform repetitive (> 2) DVIU/dilatations if urethroplasty is a viable option.
Use non-transecting excision and primary anastomosis or free graft urethroplasty instead of tEPA for short bulbar strictures not related to straddle injury.

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Treatment of Primary Single Short (< 2 cm) Non-Obliterative Bulbar Urethral Stricture in Males Eligible for Urethroplasty

References