Prospective Comparison of Direct Visual Internal Urethrotomy and Non-transecting Urethroplasty for Short Bulbar Urethral Strictures: One-year Functional and Patient-reported Outcomes
Year: 2026
Type: preprint
Abstract: Purpose : To compare one-year objective urinary outcomes, patient-reported outcomes, sexual function, recurrence, and patient satisfaction following direct visual internal urethrotomy (DVIU) and non-transecting urethroplasty for short bulbar urethral strictures over 1 year using objective uroflowmetry parameters and validated patient-reported outcome measures . Methods: A prospective observational non-randomized cohort study was conducted on patients with bulbar urethral strictures ≤2 cm in accordance with STROBE statement. Patients were allocated to three groups: DVIU, Non-Transecting Anastomosis(NTA), and Augmented NTA(ANTA). Primary outcome measures included the objective assessment with uroflowmetry and subjective assessment with USS-PROM, IPSS, CLSS, SHIM and MSHQ questionnaires at 3, 6, and 12 months. Outcomes were compared using Friedman and Kruskal Wallis tests. Results: Seventy-nine patients were enrolled: 31 underwent Direct Visual Internal Urethrotomy (DVIU), 21 Heineke-Mikulicz /Non-transecting Anastomotic Bulbar Urethroplasty (HM/NTABU), and 27 Augmented Non-Transected Anastomotic Bulbar Urethroplasty (ANTABU). One year objective urinary outcomes favoured urethroplasty. Urethroplasty groups demonstrated significantly better Qmax, USS-PROM, IPSS, and CLSS scores than DVIU (p<0.001), with higher patient satisfaction rates in HM/NTABU (90.48%) and ANTABU (92.59%) compared to DVIU (70.97%) (p=0.05).Quality-of-life outcomes (EQ-5D) were highest in the ANTABU group (p=0.038), whereas DVIU showed better preservation of erectile and ejaculatory function scores (p=0.003 and p<0.001, respectively). Post-void dribbling occurred transiently after urethroplasty and resolved by 6 months. Recurrence at 1 year was highest after DVIU (25%) compared with one recurrence after HM/NTABU and none after ANTABU (p<0.001).” Conclusions : Non-transecting urethroplasty techniques demonstrate significantly better 1-year outcomes than DVIU for short-segment, non-traumatic bulbar urethral strictures.
Source: Research Square
Institution: Kasturba Medical College, Manipal
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7214732805