1-Stage Repair of Obliterative Distal Urethral Strictures With Buccal Graft Urethral Plate Reconstruction and Simultaneous Onlay Penile Skin Flap

Gelman, Joel; Sohn, William

doi:10.1016/j.juro.2011.04.056

Cited by 34 publications

(26 citation statements)

References 8 publications

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“…If the combined approach is used, the healing of the dorsal and ventral aspect of neourethra relies on two distinct blood sources, which ultimately lead to better survival and, second, thorough fixation improves the stability of the neourethra with less possibility for retraction and recurrence . Gelman and Sohn reported favorable outcomes in their series of patients treated by a similar approach . Berglund and Angermeier proved that the combination of a buccal mucosa graft and penile or scrotal skin flap is a reliable and durable method of single‐stage repair for extensive urethral stricture disease .…”

Section: Discussionmentioning

confidence: 99%

Single‐stage repair of obliterated anterior urethral strictures using buccal mucosa graft and dorsal penile skin flap

2018

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Objective To present a single‐stage repair of obliterative urethral strictures by simultaneous use of a buccal mucosa graft and longitudinal dorsal penile skin flap. Methods Between February 2007 and October 2016, 51 patients with obliterative anterior urethral stricture underwent single‐stage substitution urethroplasty. A buccal mucosa graft was harvested and fixed to the corpora cavernosa as the dorsal part of the neourethra, and a vascularized dorsal penile skin flap was created, transposed ventrally and sutured to the buccal mucosa graft to form ventral part of the neourethra. Results The follow‐up period was 12–129 months (mean 49 months). The mean age of the patients was 48 years (range 15–71 years). The mean length of the obliterated urethral segment, measured during the operative procedure, was 5.2 cm. The etiology of strictures was: unknown, hypospadias and trauma in 19, 27 and five patients, respectively. Five patients were lost to follow up, and 46 patients were analyzed for the outcome. At the end of the follow‐up period, recurrence of the stricture occurred in seven (15.2%) patients, whereas 39 (84.8%) patients did not develop stricture. An additional three (6.5%) patients developed fistula, resulting in overall successful voiding in 36 (78.3%) patients. Conclusions A combined buccal mucosa graft and longitudinal dorsal penile skin flap could be a good choice for one‐stage substitution urethroplasty in complex obliterative urethral strictures, with an acceptable complication rate.

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Section: Discussionmentioning

confidence: 99%

Single‐stage repair of obliterated anterior urethral strictures using buccal mucosa graft and dorsal penile skin flap

2018

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“…Ventral meatotomy, onlay urethroplasty using transverse island ventral penile skin flap, two stage repair using BMG etc., are the commonly used reconstructive options for the management of distal strictures. 5,10,19,20,21,22,23,24,25,26,27 An ideal urethral substitute should have a dependable blood supply, absence of hair follicles, excellent applicability and immunity from progression of the disease process. 24,27 Urethral substitution for an obliterative process, mandates a more complex reconstructive procedure.…”

Section: Discussionmentioning

confidence: 99%

Ventral Onlay Buccal Mucosal Graft Urethroplasty Based on Tunica Vaginalis Flap for Balanitis Xerotica Obliterans Related Urethral Strictures: The Outcome of Single- Stage Reconstruction

Singh¹

2017

jmscr

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“…Ventral meatotomy, onlay urethroplasty using transverse island ventral penile skin flap, two stage repair using BMG etc.,[1234567891011] are the commonly used reconstructive options for the management of distal strictures. An ideal urethral substitute should have a dependable blood supply, absence of hair follicles, excellent applicability and immunity from progression of the disease process.…”

Section: Discussionmentioning

confidence: 99%

“…[25262728] In a recent study, Gelman and Sohn presented their experience with 1-stage reconstruction of obliterative distal urethral strictures with combined BMG urethral plate reconstruction and onlay penile skin flap. [8] They reported no urinary obstructions in 12 patients treated with this technique with a mean follow-up of 39 months. Despite presenting an attractive 1-stage alternative to tube flaps and grafts, these authors did not report on the incidence of LSA in their series.…”

Section: Discussionmentioning

confidence: 99%

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Single stage ventral onlay buccal mucosal graft urethroplasty for navicular fossa strictures

Chowdhury¹,

Nayak²,

Mallick³

et al. 2014

Indian J Urol

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Introduction:The correction of fossa navicularis strictures poses a distinct reconstructive challenge as it requires attention to cosmesis, in addition to urethral patency. Different graft and flap based repairs have been described with variable success rates. However, the ideal management remains unclear. The feasibility and efficacy of a single stage ventral onlay buccal mucosa graft urethroplasty (VOBMGU) for navicular fossa strictures (NFS) was evaluated in the present study.Subjects and Methods:All patients with NFS attending urology out-patient department from March, 2009 onward accepting VOBMGU were evaluated prospectively. Patients with minimum 1 year of follow-up were included for analysis. The technique involves opening the diseased stenosed meatus ventrally up to the corona. The diseased mucosa is excised leaving a midline strip of native urethral mucosa on the dorsal side. The buccal mucosal graft (BMG) is fixed on either side of this strip over a 24 Fr. silicone catheter. The glans wings are apposed in midline taking anchoring bites on the mucosal graft ventrally. Post-operatively patients were reviewed at 1, 3, 6 and 12 months and annually thereafter. Cosmetic acceptance and splaying of the urinary stream was assessed with individual questionnaires.Results:A total of six patients underwent VOBMGU. Average flow rate at 3 months post-operatively was 12 ml/s. The end result was cosmetically highly acceptable. There was no fistula in any of the cases. With a median follow-up of 37 months, only one patient had a recurrence of stricture in a proximal site.Conclusions:VOBMGU is a viable technique for reconstruction of NFS with promising short term results. However, long-term follow-up is necessary.

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1-Stage Repair of Obliterative Distal Urethral Strictures With Buccal Graft Urethral Plate Reconstruction and Simultaneous Onlay Penile Skin Flap

Abstract: Dorsal buccal grafting with ventral flap reconstruction appears to be an excellent option to repair circumferential urethral deficiency when penile skin is available, especially when chordee correction with distal urethral plate reconstruction is required.

Cited by 34 publications

References 8 publications

Single‐stage repair of obliterated anterior urethral strictures using buccal mucosa graft and dorsal penile skin flap

Single‐stage repair of obliterated anterior urethral strictures using buccal mucosa graft and dorsal penile skin flap

Ventral Onlay Buccal Mucosal Graft Urethroplasty Based on Tunica Vaginalis Flap for Balanitis Xerotica Obliterans Related Urethral Strictures: The Outcome of Single- Stage Reconstruction

Single stage ventral onlay buccal mucosal graft urethroplasty for navicular fossa strictures

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