Two-Staged Urethroplasty: Buccal Mucosa and Mesh Graft Techniques

Pfalzgraf, Daniel; Olianas, Roberto; Schreiter, F.; Fisch, M.

doi:10.1055/s-0029-1224664

Cited by 15 publications

(18 citation statements)

References 12 publications

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“…The rate of BMG over meshed skin grafts increased from 12 to 50 % during these two periods. Although the success rates between the two grafts were relatively equal, erectile dysfunction and chordee were only seen in the meshed graft groups with rates of 4 and 9 % respectively [ 15 ].…”

Section: Modern Surgical Variations Of Staged Urethroplastymentioning

confidence: 82%

“…In general most reconstructive urologists, including the authors, prefer buccal mucosa when adequate supply exists. Pfalzgraf et al reviewed urethroplasties performed at their institution between 1993-1999 and 2000-2004 [ 15 ]. The rate of BMG over meshed skin grafts increased from 12 to 50 % during these two periods.…”

Section: Modern Surgical Variations Of Staged Urethroplastymentioning

confidence: 99%

“…20.13 ). Erectile dysfunction has been cited to occur 4 % of the time after staged urethroplasty [ 15 ], and chordee rates range between 5 and 10 % [ 13 , 15 , 16 ]. In our experience penile curvature may occur after either fi rst-or second-stage procedures but generally resolved without need for surgical correction.…”

Section: Success Rates and Complicationsmentioning

confidence: 99%

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Staged Urethroplasty

McClung¹,

Wessells²

2013

Advanced Male Urethral and Genital Reconstructive Surgery

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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.

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Section: Modern Surgical Variations Of Staged Urethroplastymentioning

confidence: 82%

Section: Modern Surgical Variations Of Staged Urethroplastymentioning

confidence: 99%

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Staged Urethroplasty

McClung¹,

Wessells²

2013

Advanced Male Urethral and Genital Reconstructive Surgery

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“…The main disadvantage of this graft is its tendency to retract [13, 14]. We therefore advise broad spatulation of the urethral stump in order to compensate for circumferential retraction at the neomeatus.…”

Section: Discussionmentioning

confidence: 99%

Revision of Perineal Urethrostomy Using a Meshed Split-Thickness Skin Graft

Lumen

Houtmeyers

Monstrey

et al. 2014

Case Rep Nephrol Dial

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Perineal urethrostomy is considered to be the last option to restore voiding in complex/recurrent urethral stricture disease. It is also a necessary procedure after penectomy or urethrectomy. Stenosis of the perineal urethrostomy has been reported in up to 30% of cases. There is no consensus on how to treat a stenotic perineal urethrostomy, but, in general, a form of urinary diversion is offered to the patient. We present the case of a young male who underwent perineal urethrostomy after urethrectomy for urethral cancer. The postoperative period was complicated by wound dehiscence with subsequent complete obliteration of the perineal urethrostomy. Revision surgery was performed with reopening of the obliterated urethral stump and coverage of the skin defect between the urethra and the perineal/scrotal skin with a meshed split-thickness skin graft. To date, this patient is voiding well and satisfied with the offered solution.

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“…After the first description of MESH graft technique (split thickness graft) for long strictures with reasonable complication rates by Schreiter [3] in 1984, similar success rates were published years later. In the recent literature, only Pfalzgraf et al [14] have included patients operated on using the MESH graft technique in their series of two-staged urethroplasties. In the recent literature, only Pfalzgraf et al [14] have included patients operated on using the MESH graft technique in their series of two-staged urethroplasties.…”

Section: Two-stage Repair In Stricture Diseasementioning

confidence: 99%