Ventral Longitudinal Stricturotomy and Transversal Closure: the Heineke-Mikulicz Principle in Urethroplasty

ObjectivesTo describe the Heineke-Mikulicz principle in urethral surgery and to evaluate preliminary surgical and functional outcomes of this technique.MethodsTen patients (of a cohort of more than 400 patients treated with urethroplasty during a 7-year period) with a urethral stricture were treated using the Heineke-Mikulicz principle: a ventral longitudinal stricturotomy was performed with transversal closure of the urethra. Only patients with a short (<1 cm), not too narrow or fibrotic stricture at the bulbar urethra or fossa navicularis were considered as appropriate candidates. At closure of the study, all patients were sent a questionnaire about the functional outcome of the procedures. This included questions about postoperative shortening, chordee, postvoid dribbling, ejaculatory disturbances, erectile dysfunction, and penile sensitivity.ResultsMean follow-up was 46.6 months (range: 15-79 months). There were no immediate or early postoperative complications. Nine of 10 patients (90%) were successfully treated. On the questionnaire, 1 patient reported mild postoperative chordee and shortening, and 1 patient complained of postvoid dribbling. None of the sexually active patients reported ejaculatory disturbances, erectile dysfunction, or diminished penile sensitivity.ConclusionsThe preliminary surgical and functional results with the Heineke-Mikulicz principle are promising. Larger cohorts of patients are needed for further evaluation.