Experience With Ventral Penile Skin Island Flap urethroplasty

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.

One‐Stage Urethroplasty for Urethral Strictures at the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South Western Nigeria

“…There is, then, no fair basis for comparison of these methods because there are significant differences in the etiology, location, and severity of the pathology for which each method is applied. It thus questions the credibility of reports from a randomized prospective trial of the two methods [18, 19] Our finding that infection was the most common complication following one‐stage urethroplasty agrees with an earlier report from another part of Nigeria [4, 5, 10–13]. However, we noted that, unlike in those reports, recurrent stricture was more prevalent following pedicle flap repair, whereas the only urethrocutaneous fistula followed use of the excision and anastomosis technique.…”

“…It is a leading cause of urinary retention [5]. It affects all age groups, and the peak age of incidence varies among reports [4, 10, 11]. Since prevention and prompt and effective treatment of sexually transmitted infection was instituted, trauma has become the leading cause of urethral stricture worldwide [4, 12].…”