Abstract
ABSTRACTPurpose Penile skin flap uretroplasty is a useful technique for a long urethral stricture due to the ample length and surgical handling characteristics. We investigated the surgical technique and initial results of uretroplasty for anterior urethral strictures using a dorsal penile skin flap.Patients and methods From January 2003 to January 2018, a total of 77 patients underwent substitution urethroplasty using dorsal penile skin flap for bulbar urethral strictures in our institution. All patients were assessed preoperatively, and followed postoperatively by physical examination, urinalysis, retrograde and voiding urethrography, uroflowmetry and post-void residual urine measurement. Success was defined as no requirement of additional urethral instrumentation.Results The mean age was 45 years (10-87). The mean stricture length was 5cm (3-10cm). The mean flap length was 6cm. Urinary fistula was the most common postoperative complication. The mean follow-up was 60 months (6-120). The overall success rate was 88%. Recurrent strictures were found in 4 patients (5%) at 1 year. At 3 year follow-up, 5 (7%) more patients had recurrences. All recurrences were managed by internal urethrotomy.Conclusions Substitution urethroplasty using penile skin flap appear to be a safe and efficient technique for the treatment of a long and complex anterior urethral stricture. It provides encouraging cosmetic and functional results.
Highlights
Urethral stricture disease is a heterogeneous condition that often requires a wide array of surgical techniques for a successful repair
Penile skin flap can be used in long anterior urethral strictures
Patients After obtaining approval from our ethical committee (n° 212/18), we retrospectively identified a total of 77 patients who underwent urethroplasty using dorsal penile skin flap for bulbar urethral strictures in our institution
Summary
Urethral stricture disease is a heterogeneous condition that often requires a wide array of surgical techniques for a successful repair. Penile skin flap can be used in long anterior urethral strictures. In the current era of buccal mucosa, considered the donor substitute of choice for augmentation, the success of the penile skin flaps in the management of anterior urethral strictures should be reassessed. The objective of this retrospective study is to describe surgical technique, indications and initial results with dorsal penile skin flap for anterior urethral strictures. Patients After obtaining approval from our ethical committee (n° 212/18), we retrospectively identified a total of 77 patients (from January 2003 to January 2018) who underwent urethroplasty using dorsal penile skin flap for bulbar urethral strictures in our institution. For all patients we use dorsal penile skin for urethral reconstruction. Any extravasation is managed by extending the period of catheterization
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