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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

Buccal mucosa graft placed in position by quilting over the tunica of corpora cavernosa.
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f03: Buccal mucosa graft placed in position by quilting over the tunica of corpora cavernosa.

Mentions: The buccal mucosal graft is trimmed to an appropriate size and is spread and fixed (quilted) over the exposed half of the corpora. The edges of the graft are sutured to the corresponding edges of the opened urethral lumen using 4-0 polygalactin sutures (Figures 3a, 3b and 3c) over a 14Fr silicone Foley’s catheter. In those cases with external urethral involvement, the dorsal meatotomy incision allowed us to widen the narrow meatus/fossa navicularis region and draw the graft in through the glans from the distal urethrotomy and place it right up to the tip of the external meatus (Figures 4a and 4b). After completion of anastomosis, the wound is closed in layers (Figure-5). The periurethral catheter is left in-situ for 3-4 weeks.


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)

Buccal mucosa graft placed in position by quilting over the tunica of corpora cavernosa.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f03: Buccal mucosa graft placed in position by quilting over the tunica of corpora cavernosa.
Mentions: The buccal mucosal graft is trimmed to an appropriate size and is spread and fixed (quilted) over the exposed half of the corpora. The edges of the graft are sutured to the corresponding edges of the opened urethral lumen using 4-0 polygalactin sutures (Figures 3a, 3b and 3c) over a 14Fr silicone Foley’s catheter. In those cases with external urethral involvement, the dorsal meatotomy incision allowed us to widen the narrow meatus/fossa navicularis region and draw the graft in through the glans from the distal urethrotomy and place it right up to the tip of the external meatus (Figures 4a and 4b). After completion of anastomosis, the wound is closed in layers (Figure-5). The periurethral catheter is left in-situ for 3-4 weeks.

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