Simplified posterior urethroplasty utilizing laparoscopic instrumentation.

Background: Posterior urethral stricture disease presents challenges for even the most skilled reconstructive urologists. Regardless of the surgical technique used, these are complex operations that occur in hard-to-access locations. We describe the use of a novel combination of laparoscopic instrumentation to simplify posterior urethral reconstruction.

Methods: We retrospectively identified patients undergoing a posterior urethral stricture repair utilizing a combination of the RD-180 suture device and the Securestrap. These procedures were performed by a single surgeon at our institution. Patients with greater than or equal to 4 months of follow up were included in the analysis.

Results: From October 2016 to October 2020, 20 patients underwent posterior urethral stricture repair using these laparoscopic instruments. Median age was 70 years (28-90 years). Median follow up was 12 months (5-50 months). Mean stricture length was 3 cm (1.5-16 cm). Median operative time was 150 minutes (120-180 minutes). No peripheral neuropathies or positional injuries were noted. With failure defined as inability to pass a 16-Fr scope, success rate was 95% (19/20 patients).

Conclusions: The combination of the RD-180 and the Securestrap has become essential to our posterior urethral stricture repair armamentarium. Further data and longer follow up is needed to confirm these reliable outcomes.