Staged Urethroplasty

Abstract

SummaryStaged urethroplasties are characterized by a planned repair involving more than one surgery to fi x a urethral stricture, obliteration, diverticulum, fi stula, or combination of the above. Common indications for a staged urethroplasty included failed hypospadias surgery, multiple prior urethroplasty failures, and strictures associated with lichen sclerosus. Because excision and primary anastomosis has a signifi cant potential to produce postoperative chordee, staged procedures are more commonly used in the penile urethra relative to the bulbar urethra. Free tissue transfer is inherent to staged urethroplasties; common donor sources include buccal mucosa and split thickness skin. Preservation of the native urethral plate in selected cases allows maximization of donor graft with limited availability. A technical description of the staged urethroplasty is followed by a review of published success rates, which range from 73 to 100 %. Common complications of a staged repair include need for additional revisional surgery, fi stula, postoperative curvature, and recurrent stricture.