You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery1 Apr 201185 SINGLE-STAGE SEGMENTAL NEOURETHRAL FORMATION WITH VENTRAL ONLAY FASCIOCUTANEOUS FLAP AND DORSAL BUCCAL URETHRAL PLATE REPLACEMENT Bradley Erickson, Benjamin Breyer, and Jack McAninch Bradley EricksonBradley Erickson Iowa City, IA More articles by this author , Benjamin BreyerBenjamin Breyer San Francisco, CA More articles by this author , and Jack McAninchJack McAninch San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.150AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In long-segment penile urethral stricture disease, where a portion of the existing urethral plate must be completely resected, two-stage repairs are often advocated, since tubularization procedures have historically poor outcomes. In select patients, we have offered a unique single-stage repair that incorporates two distinct tissue sources relying on two separate blood supplies which we theorized would improve our results. METHODS Our prospective urethroplasty database was reviewed for patients where a dorsal onlay buccal mucosa graft was combined with a ventral onlay fasciocutaneous flap to circumferentially replace an entire diseased urethral segment. In all cases, both the flap and the graft were secured to the lateral edges of the corpus cavernosum and the diseased urethra was completely excised. Primary success was defined as an open urethra at > 1 year follow-up with no need for additional surgical intervention, secondary success as the need for ≤ 2 post-operative endoscopic procedures, and failures as need for repeat urethroplasty, urinary diversion or chronic catheterization. RESULTS There were 12 patients included, with stricture etiologies of trauma (5), urethral stent (2), hypospadias cripple (1) and idiopathic (4). The mean stricture length was 9.75 ± 4.6 cm and mean neourethral length was 5.4 ± 2.7 cm. Stricture location was penile/bulbar in 10, and bulbar in 2. Primary success was achieved in 7(58%) patients at a mean follow-up time of 3.73 ± 2.9 years. Median time to recurrence was 11.4 (0.9 to 33.1) months. Secondary success was achieved in 2 patients after 1 and 2 endoscopic procedures, for an overall success rate of 75%. Failure was associated with longer strictures (12.8 vs 8.7, p = 0.04) than initial successes, but neourethal lengths were similar (6.2 v 5.1, p = 0.5). Of the 3 (25%) that failed, one underwent repeat urethroplasty and 2 now require intermittent catheterization. No patients experienced repair breakdown or post-operative fistula formation. CONCLUSIONS Our initial outcomes were favorable using the combined tissue transfer technique for segmental urethral replacement with initial and secondary success rates similar to those reported for two stage repairs. This technique is not suitable for all patients as it requires healthy penile skin, but appears to be an effective single-stage option for long-segment repairs where a segment of urethra must be entirely replaced. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e37 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bradley Erickson Iowa City, IA More articles by this author Benjamin Breyer San Francisco, CA More articles by this author Jack McAninch San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...