Abstract
stricture was approached through perineal incision with penile invaginationto provide access to the entire length of anterior urethra in 1 stage. One sided, dorsal onlay technique was performed. Two/three oral mucosal grafts were placed dorsally. In redo cases where prior dorsal approach was used, a full-length ventral incision with dorsal inlay grafts was inserted. Postoperatively catheter was removed at 4 weeks. Follow up interval was at 3,6,9,12 months and subsequently yearly. RESULTS: Median patient age was 48.8 years, mean stricture length 14 cm and median follow-up 46 months. 184(57.75%) patients had LS and 134(42.25%) had other causes. Success rate for LS and non-LS was same 85.2%. Retention with suprapubic catheter (SPC) suggests obliterative stricture. Success rate decreased to 57.10% if patient had retention or SPC. On analysis of retention, it was seen in 60.3% patients with iatrogenic cases. Last 3 years 26 patients were referred with retention and SPC. Of this 17(65.33%.) were because iatrogenic cause The outcome was considered a success if the patient required no further instrumentation, including dilation or urethrotomy. The success rate was 89.39% for primary urethroplasty and 57.85% in patients in redo group. Most recurrent strictures developed at the proximal end of the graft. Only 3/318 patients had raised creatinine/renal failure. So raised creatinine and renal failure is less likely with panurethral stricture. CONCLUSIONS: Repair of panurethral stricture in 1 stage with 1-side dissection and dorsal onlay of oral mucosa graft is a minimally invasive technique that is simple, fast, safe, effective and reproducible by any surgeon. The incidence of iatrogenic panurethral strictures is on the rise. Iatrogenic strictures are more likely to be obliterative with early presentation.
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