Journal article
Single-stage segmental urethral replacement using combined ventral onlay fasciocutaneous flap with dorsal onlay buccal grafting for long segment strictures
BJU international, Vol.109(9), pp.1392-1396
05/01/2012
DOI: 10.1111/j.1464-410X.2011.10483.x
PMCID: PMC3557856
PMID: 21880103
Abstract
OBJECTIVE
To present our experience with repairing long-segment urethralstrictures in a single-stage using a combined tissue-transfer technique.
PATIENTS AND METHODS
In all, 14 men underwent urethroplasty where a segment of urethra was completely replaced using a dorsal onlay buccal mucosa graft and a ventral onlay fasciocutaneous flap in a singlestage.
Primary success was defined as an open urethra at >6 months follow-up with no need for additional surgical intervention.
Secondary success was defined as the need for a single postoperative endoscopic procedure before stricture stabilization.
Failure was the need for multiple endoscopic procedures, repeat urethroplasty, urinary diversion or intermittent dilatation.
RESULTS
The mean (SD) stricture length was 9.75 (4.6) cm. The mean (SD) neourethral length was 5.4 (2.7) cm. Stricture location was penile/bulbar in 12men, and bulbar alone in two. Primary success was achieved in nine of the 14 men at a median (range) follow-up of 2.5 (0.5-9.43) years.
The mean (SD) time to recurrence in the five initial failures was 340 (376) days.
Secondary success was achieved in two men after a single endoscopic procedure for an overall success in 11 of 14 men.
Patients that recurred had longer strictures (12.8 vs 8.7 cm, P = 0.04) than initial successes, but neourethral lengths were similar (6.2 vs 5.1 cm, P = 0.5).
In all, three of the 14 men failed, two of whom required a repeat urethroplasty.
CONCLUSIONS
Our initial outcomes were favourable 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 effective when a single-stage repair is desirable.
Details
- Title: Subtitle
- Single-stage segmental urethral replacement using combined ventral onlay fasciocutaneous flap with dorsal onlay buccal grafting for long segment strictures
- Creators
- Bradley A. Erickson - University of California, San FranciscoBenjamin N. Breyer - University of California, San FranciscoJack W. McAninch - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.109(9), pp.1392-1396
- Publisher
- Wiley
- DOI
- 10.1111/j.1464-410X.2011.10483.x
- PMID
- 21880103
- PMCID
- PMC3557856
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Number of pages
- 5
- Grant note
- K12 DK083021 / NIDDK NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) K12DK083021 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 05/01/2012
- Academic Unit
- Urology
- Record Identifier
- 9984319992302771
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