Article

One-stage urethroplasty for complicated urethral strictures using axial penile skin island flap.

Department of Surgery, Lagos University Teaching Hospital, Nigeria.
European Urology (impact factor: 8.49). 02/1990; 17(1):79-84. pp.79-84
Source: PubMed

ABSTRACT Surgical repair of urethral strictures complicated by multiple scrotal/perineal urethrocutaneous fistulae (watering-can perineum) can be very problematic. The perineal/scrotal skin is either not available or is riddled with infection, fibrosis or granulomata and therefore unsuitable as a graft source. The presence of infection makes free grafts from other sites unlikely to survive. Furthermore, extensive fibrosis may prevent excision and re-anastomosis as well as internal urethrotomy. The absence of preputial skin in circumcised patients compounds these problems. We have used a one-stage, transverse vascularized cutaneous penile flap to repair 20 cases of these complicated strictures. The graft took in 100% and no absolute repair failure was registered. In spite of obvious pre-operative infection, the result of repair was judged excellent in 17 patients (85%) and very fair in 3 (15%).

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    Article: Experience With Ventral Penile Skin Island Flap urethroplasty
    I O Ntia, I A Mungadi
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    ABSTRACT: Background: Island flap techniques currently used in urethroplasty utilize the prepuce and the dorsal penile skin. Our experience with a one-stage island flap urethroplasty for urethral strictures utilizing the ventral penile skin is described. Patients and Method: This is a longitudinal study of seventy six consecutive patients with impassable and complicated urethral strictures treated using this technique over a seven-year period. Sixty were bulbous while sixteen were bulbomembranous urethral strictures. Following operation the patients were assessed using urine flow rates, urethrograms and some urethroscopy. Restrictures were successfully reoperated. Results: Sixty-eight patients (89.5%) had satisfactory voiding with good urine stream without complication at one year after operation. Five patients (6.6%) had restricture and three (3.9%) others had urethral bagginess and postmicturition dribbling. The overall complication rate was 10.5%. At three years after initial operation and reoperation seventy-five patients (98.7%) were voiding satisfactorily. There was one complete failure, no death. Conclusion: This technique has produced satisfactory results compared with other similar techniques in current use. Further work is required to make valid conclusions about the value of this procedure.
    Nigerian Journal of Surgical Research (ISSN: 1595-1103) Vol 8 Num 3-4.
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Keywords

17 patients
 
circumcised patients compounds
 
extensive fibrosis
 
fair
 
graft source
 
granulomata
 
internal urethrotomy
 
multiple scrotal/perineal urethrocutaneous fistulae
 
obvious pre-operative infection
 
perineal/scrotal skin
 
preputial skin
 
problems
 
re-anastomosis
 
spite
 
transverse vascularized cutaneous penile flap
 
urethral strictures
 

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