Application of Dorsal Preputial Island Flap in Meatoplasty

Abstract

Introduction and Objectives: Meatal stenosis usually presents in adults with a history of urethral trauma or inflammation or as a complication after hypospadias repair. The objective of this study is to present the correction of meatal stenosis using a preputial island flap, created on the dorsal surface of the penis. Methods: During the last 3 years 12 patients were subjected to meatoplasty using a preputial flap. A meatotomy was performed and a preputial island flap was raised on the dorsal surface of the penis, that was brought to the ventral surface and anastomosed to the opened fossa navicularis. Results: Mean follow-up is 22.3 (range 6–40) months and urethral meatus remains normal with good caliber in routine examination mainly with dilators and uroflowmetry. Conclusions: The described method was based on the on-lay preputial island flap procedure (Duckett’s method) for correction of anterior hypospadias. The cosmetic result is excellent and normal penile morphology and function are well preserved.

Tailored sutureless meatoplasty: A new technique for correcting meatal stenosis

“…Hrebinko successfully used the carbon dioxide laser in patients with meatal stenosis associated with balanitis xerotica obliterans [10]. Radopoulos et al described an onlay procedure with dorsal preputial skin in adults with traumatic stenosis [11] and Malone described a ventral and dorsal meatotomy with a V relaxing incision to create a slitlike meatus in men with a history of meatal stenosis from lichen sclerosis [12].…”

Wedge meatoplasty as a treatment for stricture of the urethral meatus in a cat

“…20 Sounding was considered inappropriate in this case as repeated sedation or general anaesthesia would be required and because of concern that the apparent fibrosis around the meatus would limit its effectiveness. Various meatoplasty techniques have been used for treatment of meatal stricture in humans including ventral transverse island fasiculocutaneous penile flap 21 , dorsal and ventral meatotomy with a v-shaped relieving incision, 22 eversion meatoplasty, 23 resection and primary end-to-end anastomosis, 24 meatoplasty with double buccal mucosa grafts, 25 or a dorsal preputial island flap 26 and meatoplasty with various other local skin flaps or free skin grafting. 11 Here, a simple wedge meatoplasty similar to the eversion meatoplasty described by el-Kasaby et al 23 and the Mathieu and a V incision sutured (MAVIS) modification of the Mathieu technique for hypospadias repair 27 was used: more complicated techniques involving flaps or grafts were considered inappropriate because of the small diameter of the cat's urethra.…”

“…Postoperative complications after meatoplasty in humans include abnormal urine stream, [23][24][25][26] glanular torsion, 24 abnormal appearance of the meatus, 27 wound dehiscence, 11,28 fistula formation 27,28 and stricture formation 24 . Complications were not seen in this case.…”