Clinical study of transverse island fasciocutaneous fascia flap for treatment of meatus and navicular fossa stricture

Abstract

Objective To investigate the clinical effect of transverse island fasciocutaneous penile flap in the treatment of meatus and navicular fossa stricture. Methods Fifteen patients with urethral reconstruction with transverse island fasciocutaneous penile flap from October 2014 to December 2018 were enrolled. Six patients had a history of urethroscopic surgery, three had a history of lichensclerosus, three had a history of urethral dilation, and three had no obvious causes. All patients underwent transverse incision under the coronal sulcus, and after fully dissecting the urethra, the urethra was opened longitudinally ventrally. After measuring the actual length of stenosis, the irradiance fascia flap with the corresponding length of the incision was reconstructed. The patients were reviewed at 1 and 3 months after operation, and any complications such as recurrence or urinary fistula were recorded. The urine flow rate was tested 3 months after surgery. Results All 15 patients in this group underwent a successfully operation. The actual measurement of urethral stricture length was 0.5-4.0 cm during operation, with the average of 2.82 cm. Three months after the operation, the urine flow rate ranged from 13.5 ml/s to 23.7 ml/s, with an average of 18.5 ml/s. The overall successful rate was 93.3%(14/15). The rate of post-operative fistula was 20.0%(3/15). Two cases complained of needle-like fistula at the incision. One case healed after 3 months, and the other gave up further treatment. One patient developed urethral stricture and urethral skin spasm again 1 month later and was surgically repaired again. Conclusions The initial experience of pedicled island fascia flap for the treatment of urethral stenosis and scaphoid stenosis is safe, feasible and effective for the treatment of urethral stricture. Key words: Uethral stricture; Navicular fossa; Pedical flap; Urethral reconstruction