Innovative approach to surgical urethral stricture management

Oct. 04, 2024

Mayo Clinic's reconstructive urology team, which includes Katie T. Anderson, M.D., Boyd R. Viers, M.D., and Nick Warner, M.D., is setting a new standard in the management of male and female urethral strictures.

This team at Mayo Clinic is the only one in the U.S. that offers a comprehensive range of definitive treatment options that are tailored to the patient, including transluminal urethral surgery, known as TRAMUS, open surgery and robotic repairs. "We have the skill set amongst the three of us to offer each patient the best possible surgical option," says Dr. Anderson.

Surgical approaches

Urethra reconstruction Urethra reconstruction

The specialized transluminal technique to repair urethral strictures allows for definitive reconstruction through the natural urethral opening without incision.

Mayo Clinic is the first institution in the U.S. to offer specialized transluminal techniques to treat urethral strictures in both men and women. The urethral stricture is opened in a transluminal approach. From here, definitive reconstruction occurs via the primary reapproximation of the healthy urethra, or a graft is deployed and fixed from the mouth across the incised area. This is all done through the natural urethral opening without the need for an external incision.

The benefit of this approach is that it is a much more precise and efficient operation. Without extensive incisions and dissection of the surrounding structures, the risks of the surgery are reduced, including bleeding, sexual dysfunction and infections, and there is a faster recovery time.

In some situations, the TRAMUS approach is not appropriate, and an open repair may be required. Alternatively, some patients may be good candidates for drug-coated balloon dilation. Lastly, advanced robotic reconstruction solutions are possible, as in cases of posterior urethral trauma from motor vehicle accidents or due to prostate cancer therapy.

Urethral stricture case conference

Each team member has fellowship training, bringing unparalleled expertise to the evaluation and treatment of urethral strictures. The team's collaborative approach includes detailed case conferences, where every stricture is evaluated to determine the most effective treatment strategy based on its location and etiology. This personalized care considers the underlying cause of the stricture, whether it stems from infection, trauma, radiation therapy or complications of surgical prostate cancer treatment.

"We have the unique advantage of working in a multidisciplinary team environment, including with our urologic oncology colleagues, colorectal surgeons and orthopedic surgeons, whom we can easily collaborate with in difficult situations," says Dr. Viers.

Mayo Clinic's reconstructive urology team is dedicated to advancing the field of urology through innovative treatments and a patient-centered approach. With their pioneering techniques, team members are leading the way in the management of urethral strictures, offering hope and healing to patients from around the world.

For more information

Refer a patient to Mayo Clinic.