Management of penile urethral strictures: Challenges and future directions

Campos-Juanatey, Félix; Bugeja, Simon; Ivaz, Stella; Frost, Anastasia; Andrich, Daniela E.; Mundy, Anthony R.

doi:10.5410/wjcu.v5.i1.1

Cited by 6 publications

(12 citation statements)

References 70 publications

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“…The most common aspects to correct in adulthood are strictures, fistulas, diverticula, and persistent hypospadic location of the neomeatus [ 8 ]. Several aspects made the reconstruction complex [ 11 ]: poorly vascularized tissues after previous surgeries, congenital absence of corpus spongiosum, lack of skin and coverage tissues, and psychological issues of patients, avoiding further interventions, as we presented in our case.…”

Section: Discussionmentioning

confidence: 95%

“…In addition, only a few cases maintained an established protocol of prolonged routine checks over time. This is important since pubertal growth can change the cosmetic and functional aspects of the penis, with the appearance of new curvatures, affecting psychosexual development [ 11 ]. This is especially relevant in repairs using hair-bearing skin, like scrotal tubes or dorsal penile skin as in our case [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…We should discuss whether urethral dilations are suitable for maintaining long-term patency or a new surgical intervention is required. In some cases, increasing urethral calibre by dorsal or ventral augmentation using grafts or flaps is feasible [ 11 ]. However, it is usually required to perform a complete urethral reconstruction after removing previous repairs.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Undesirable Consequences of Penile Skin Island Flap to Correct Penoescrotal Transposition: A Case Report and Review of Literature

Varea-Malo

Revuelta

Campos-Juanatey

et al. 2021

Case Reports in Urology

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Hypospadias is a congenital malformation of the male lower urinary tract, consisting of a ventral urethral opening proximal to the glans penis. This condition is corrected surgically in the paediatric age, with a great variety of techniques available. Traditionally, a tubularized genital skin was used for one- or two-stage repairs. Nowadays, the tendency is to use preputial or oral mucosa grafts, dorsally located, to avoid diverticula formation and prevent hair growth in the neourethra. We present a case of a patient born with proximal hypospadias with penoscrotal transposition, surgically corrected in his childhood, using dorsal penile skin island flap. The patient is referred to urology consultation in his adulthood for a weak urinary stream, recurrent infections, and a large amount of hair exiting through the urethral meatus.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-Term Undesirable Consequences of Penile Skin Island Flap to Correct Penoescrotal Transposition: A Case Report and Review of Literature

Varea-Malo

Revuelta

Campos-Juanatey

et al. 2021

Case Reports in Urology

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“…Penile urethroplasty has evolved significantly over the last eight decades, since the first attempts at reconstruction using preputial tubes or a staged approach using penile skin [95]. An improved understanding of the pathophysiology of LS and a high complication rate following skin-based reconstructions favored a shift to the use of oral mucosal grafts, particularly in LS strictures.…”

Section: Future Directions and Goalsmentioning

confidence: 99%

“…Currently, one of the critical limitations of penile urethroplasty is the common need for a staged reconstruction with all the inconveniences for the patient, and a 20-31% incidence of graft failure following the first stage, which leads to further revision(s) prior to the final tubularization [95]. Insufficient oral mucosal grafts for panurethral stricture reconstruction, especially in redo cases, add serious problems.…”

Section: Future Directions and Goalsmentioning

confidence: 99%

Historical Perspective and Innovations in Penile Urethroplasty

Martins¹,

Oliveira²,

Martins³

2020

Lower Urinary Tract Dysfunction - From Evidence to Clinical Practice

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Penile urethral strictures are common and impact on quality of life and healthcare costs. Management of penile urethral strictures is complex and depends on the physical characteristics of the stricture. Contemporary studies show no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes. Overall, long-term success rates range from 20 to 30%. However, their recurrence rate is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures, which make them less cost-effective. Surgical urethroplasty is associated with higher long-term success rates, averaging from 85 to 90%, mostly in virgin or noncomplex cases. Historically, modern urethral reconstruction has evolved from 1950s with the revolutionary introduction of Johanson's technique for staged urethral reconstruction. Since then, many techniques have been developed and employed for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques.

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Penoscrotal fistula secondary to urethral diverticulum treated with ventral penile skin flap urethroplasty: A case report

Tuygun

Aghayev

Durak

et al. 2022

Urology Case Reports

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Voiding symptoms and penoscrotal mass with/without fistula are typical findings of urethral diverticulum. We present a case of 55-year-old male patient who was evaluated for voiding symptoms, soft palpable penoscrotal mass and fistula. Retrograde urethrography, scrotal ultrasonography and cystoscopy revealed a urethral diverticulum and fistula. The defect developed after excision of the diverticulum associated with the penile ventral urethra was closed with a penile skin flap. In the 6-month follow-up, the patient did not have any voiding complaints and no signs of recurrence. Urethroplasty using a penile skin flap may be preferred in the repair of penile ventral urethral defect.

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Management of penile urethral strictures: Challenges and future directions

Cited by 6 publications

References 70 publications

Long-Term Undesirable Consequences of Penile Skin Island Flap to Correct Penoescrotal Transposition: A Case Report and Review of Literature

Long-Term Undesirable Consequences of Penile Skin Island Flap to Correct Penoescrotal Transposition: A Case Report and Review of Literature

Historical Perspective and Innovations in Penile Urethroplasty

Penoscrotal fistula secondary to urethral diverticulum treated with ventral penile skin flap urethroplasty: A case report

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