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Two-sided urethra-sparing reconstruction combining dorsal preputial skin plus ventral buccal mucosa grafts for tight bulbar strictures.

Authors :
Palminteri E
Berdondini E
Florio M
Cucchiarale G
Milan G
Valentino F
Sedigh O
Di Pierro GB
Source :
International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2015 Sep; Vol. 22 (9), pp. 861-6. Date of Electronic Publication: 2015 May 25.
Publication Year :
2015

Abstract

Objectives: To report our initial experience with urethra-sparing reconstruction combining dorsal preputial skin and ventral buccal mucosa grafts for tight bulbar urethral strictures.<br />Methods: Between November 2006 and September 2012, 26 patients with tight bulbar strictures underwent urethroplasty. Using a ventral urethrotomy approach, the two-sided urethral reconstruction was carried out avoiding the transection of urethra and augmenting the preserved urethral plate by dorsal preputial skin plus ventral buccal mucosa grafts. The primary outcome was the objective urinary result, defined as the absence of stricture recurrence. The outcome was considered a failure when any postoperative instrumentation was required. Postoperative sexual dysfunctions were investigated using a validated questionnaire.<br />Results: Mean follow up was 30.1 months (range 12-79 months). Mean stricture length was 3.3 cm (range 1.5-6 cm). Mean length for dorsal preputial skin and ventral buccal mucosa grafts was 3.2 cm (range 2-7 cm) and 4.9 cm (range 4-6 cm), respectively. Of 26 cases, 23 (88.5%) were successful and three (11.5%) were failures with stricture recurrence. Failures were treated with perineal urethrostomy in one case, ventral buccal graft urethroplasty in one case and internal urethrotomy in one case. Among 12 sexually active men preoperatively, none reported postoperative penile curvature/shortening, impaired erection or dissatisfaction regarding erection; sexual activity was unaltered pre- and post-surgery.<br />Conclusions: In tight bulbar urethra strictures, the two-sided urethroplasty combining dorsal preputial skin and ventral buccal mucosa grafts provides a safe and effective semi-circumferential reconstruction by augmenting the preserved urethral plate, with no impact on sexual function.<br /> (© 2015 The Japanese Urological Association.)

Details

Language :
English
ISSN :
1442-2042
Volume :
22
Issue :
9
Database :
MEDLINE
Journal :
International journal of urology : official journal of the Japanese Urological Association
Publication Type :
Academic Journal
Accession number :
26010048
Full Text :
https://doi.org/10.1111/iju.12822