Reconstruction of traumatic posterior urethral strictures.

Reconstruction of posterior urethral disruption injuries is an extremely challenging surgical exercise even in the best of hands. A perineal anastomotic technique is successful in the vast majority of cases. Adequate excision of fibrotic tissue is of paramount importance in ensuring successful outcomes. A wide-caliber, spatulated tension-free bulboprostatic anastomosis is the goal of surgical reconstruction. Excellent long-term results can be expected from anastomotic urethroplasty in patients with traumatic posterior urethral strictures. Nearly all patients can void normally and retain continence postoperatively. Subsequent urethrotomy, when required, carries a high likelihood of success. A significant number of patients regain potency after urethral reconstruction. Persistent impotence probably reflects the severity of pelvic trauma.