Clinical research with inverted L-shaped penis pedicle flap treatment of complicated long segment anterior urethral stricture

Abstract

Objective To explore the therapeutic effect of using inverted L-shaped penis pedicle flap to treat complicated long segment anterior urethral stricture.Methods From June 2008 to November 2011,12 male patients with long segment anterior urethral stricture were treated in our hospital.The length of urethral stricture was from 8 cm to 14 cm (mean 10 cm).The age was from 28 to 72 years (mean 56 years).In our operation,we cut through the urethral stricture segment to the point that was 1 cm to the normal urethral mucosa.We gained the L-shaped flap from penile ventral that was longitudinal and was transverse extension to the Coronal Sulcus.Two apices of the L-shaped flap were sutured to the proximal and distal apices of the urethrotomy with 5-0 polyglactin interrupted stitches.The margins of the opened urethra were sutured to the L-shaped flap with 5-0 polyglactin running sutures.Results The patients were followed up for 6-38 months postoperatively (mean 21 months).Of the 12 cases,10 cases voided well and the urinary peak flows ranged from 17.0 to 24.5 ml/s (mean 19.8 ml/s).Urinary fistula occurred in 1 case,and the patient was cured after the second repair operation 6 months later.Only 1 case had urethral stricture in navicular fossa 6 months after the operation and was cured by cold knife incision treatment.Conclusions Inverted L-shaped penis flap is easy to get and the operation is not complicated.So inverted L-shaped penis flap is a good material in the treatment of complicated long segment anterior urethral stricture. Key words: Urethral stricture; Surgical flaps; Foreskin; Surgical procedures, operative