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Single stage: dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures using perineal route.

Prabha V, Devaraju S, Vernekar R, Hiremath M - Int Braz J Urol (2016 May-Jun)

Bottom Line: Procedure was considered to be failure if the patient required instrumentation postoperatively.Mean follow-up was 22.7 months (range 12 to 36 months).Overall success rate was 85%.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, KLE University's JN Medical College, Belgaum, India.

ABSTRACT

Objective: To assess the outcome of single stage dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures (>4cm long) using a perineal incision.

Materials and methods: From August 2010 to August 2013, 20 patients underwent BMG urethroplasty. The cause of stricture was Lichen sclerosis in 12 cases (60%), Instrumentation in 5 cases (25%), and unknown in 3 cases (15%). Strictures were approached through a perineal skin incision and penis was invaginated into it to access the entire urethra. All the grafts were placed dorsolaterally, preserving the bulbospongiosus muscle, central tendon of perineum and one-sided attachement of corpus spongiosum. Procedure was considered to be failure if the patient required instrumentation postoperatively.

Results: Mean stricture length was 8.5cm (range 4 to 12cm). Mean follow-up was 22.7 months (range 12 to 36 months). Overall success rate was 85%. There were 3 failures (meatal stenosis in 1, proximal stricture in 1 and whole length recurrent stricture in 1). Other complications included wound infection, urethrocutaneous fistula, brownish discharge per urethra and scrotal oedema.

Conclusion: Dorsolateral buccal mucosal urethroplasty for long anterior urethral strictures using a single perineal incision is simple, safe and easily reproducible by urologists with a good outcome.

No MeSH data available.


Related in: MedlinePlus

Dissection up to level of bulbo spongeosis with long stricure in penile and bulbar urethra.
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f01: Dissection up to level of bulbo spongeosis with long stricure in penile and bulbar urethra.

Mentions: Operation was performed under general anesthesia with nasal intubation. Two teams worked simultaneously, one at the donor site and other at the recipient site. Urethroscopy was performed using a 6-7.5Fr semi rigid (Karl Storz) ureteroscope and a hydrophilic (Terumo) guide wire was passed into the bladder. A 5fr ureteric catheter was guided over it and the ureteric catheter was secured with a stich on the glans. A midline perineal skin incision is made; the bulbar urethra is exposed, preserving the midline tendon of the perineum and bulbospongiosus muscle (Figure-1). The involved bulbar urethra is dissected off the corpora cavernosa on the left side, so as to leave the right half attached and preservation of its lateral blood supply.


Single stage: dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures using perineal route.

Prabha V, Devaraju S, Vernekar R, Hiremath M - Int Braz J Urol (2016 May-Jun)

Dissection up to level of bulbo spongeosis with long stricure in penile and bulbar urethra.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920576&req=5

f01: Dissection up to level of bulbo spongeosis with long stricure in penile and bulbar urethra.
Mentions: Operation was performed under general anesthesia with nasal intubation. Two teams worked simultaneously, one at the donor site and other at the recipient site. Urethroscopy was performed using a 6-7.5Fr semi rigid (Karl Storz) ureteroscope and a hydrophilic (Terumo) guide wire was passed into the bladder. A 5fr ureteric catheter was guided over it and the ureteric catheter was secured with a stich on the glans. A midline perineal skin incision is made; the bulbar urethra is exposed, preserving the midline tendon of the perineum and bulbospongiosus muscle (Figure-1). The involved bulbar urethra is dissected off the corpora cavernosa on the left side, so as to leave the right half attached and preservation of its lateral blood supply.

Bottom Line: Procedure was considered to be failure if the patient required instrumentation postoperatively.Mean follow-up was 22.7 months (range 12 to 36 months).Overall success rate was 85%.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, KLE University's JN Medical College, Belgaum, India.

ABSTRACT

Objective: To assess the outcome of single stage dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures (>4cm long) using a perineal incision.

Materials and methods: From August 2010 to August 2013, 20 patients underwent BMG urethroplasty. The cause of stricture was Lichen sclerosis in 12 cases (60%), Instrumentation in 5 cases (25%), and unknown in 3 cases (15%). Strictures were approached through a perineal skin incision and penis was invaginated into it to access the entire urethra. All the grafts were placed dorsolaterally, preserving the bulbospongiosus muscle, central tendon of perineum and one-sided attachement of corpus spongiosum. Procedure was considered to be failure if the patient required instrumentation postoperatively.

Results: Mean stricture length was 8.5cm (range 4 to 12cm). Mean follow-up was 22.7 months (range 12 to 36 months). Overall success rate was 85%. There were 3 failures (meatal stenosis in 1, proximal stricture in 1 and whole length recurrent stricture in 1). Other complications included wound infection, urethrocutaneous fistula, brownish discharge per urethra and scrotal oedema.

Conclusion: Dorsolateral buccal mucosal urethroplasty for long anterior urethral strictures using a single perineal incision is simple, safe and easily reproducible by urologists with a good outcome.

No MeSH data available.


Related in: MedlinePlus