Penile inversion through a penoscrotal incision for the treatment of penile urethral strictures

Abstract

PurposeThis article describes a novel technique for the repair of penile urethral strictures and establishes the safety, feasibility, and efficacy of this innovative surgical approach.Materials and MethodsPatients with urethral strictures underwent a one-sided anterior dorsal oral mucosal graft urethroplasty through a penoscrotal inversion technique. The clinical outcome was considered a failure when any instrumentation was needed postoperatively, including dilatation.ResultsFive patients underwent the novel procedure. The patients' mean age was 58 years. The cause of stricture was instrumentation in 2 cases (40%), lichen sclerosis in 1 case (20%), and failed hypospadias repair in 2 cases (40%). The mean stricture length was 3 cm. The overall mean (range) follow-up was 6 months (range, 3–9 months). Of the 5 patients, 4 (80%) had a successful outcome and 1 (20%) had a failed outcome. The failure was successfully treated by use of a meatotomy.ConclusionsThe penile inversion technique through a penoscrotal incision is a viable option for the management of penile urethral strictures with several advantages to other techniques: namely, no penile skin incision, a single-stage operation, and supine positioning.

Aspects épidémiologiques, cliniques et prise en charge de sténose urétrale chez l’adulte dans un Hôpital de District de Ngaoundéré, Cameroun

“…Des taux semblables étaient obtenus dans plusieurs études similaires [8, 15]. Par ailleurs, aucun cas de décès n’a été notifié.…”

“…Les suites opératoires ont été favorables avec 87,73% de réussite contre 12,27% de récidives. Des taux semblables étaient obtenus dans plusieurs études similaires [ 8 , 15 ]. Par ailleurs, aucun cas de décès n’a été notifié.…”

Multi‐institutional review of non‐hypospadiac penile urethral stricture management and outcomes

“…The penoscrotal incision with inversion technique was first described by our group in 2016. 16 This novel approach spares patients the morbidity of perineal incision while preserving surgical success rates expected via more traditional perineal incision. Ventral inlay of BMG via a transurethral approach is another novel technique described by our group for management of strictures in the fossa navicularis.…”

“…[8][9][10] In addition, many approaches to the repair of a penile urethral stricture have been described. [11][12][13][14][15][16] Few studies have analyzed penile strictures after excluding hypospadias and glans-limited disease. To collect granular data and understand surgical approaches and patient outcomes for penile urethral strictures not attributable to hypospadias, we pooled contemporary data from 13 centers.…”

“…Many studies include patients with hypospadias in their cohorts, which is a completely different pathophysiology, being a congenital deficiency in urethral tissue as opposed to scarring of a normal urethra 8–10 . In addition, many approaches to the repair of a penile urethral stricture have been described 11–16 . Few studies have analyzed penile strictures after excluding hypospadias and glans‐limited disease.…”