One-sided anterior urethroplasty: A new dorsal onlay graft technique

Sanjay Kulkarni, Guido Barbagli, Salvatore Sansalone, Massimo Lazzeri

Research output: Contribution to journalArticle

Abstract

Objective To investigate the feasibility, tolerability, safety and efficacy of using a new surgical technique for the repair of anterior urethral strictures to preserve vascular supply to the urethra and its entire muscular and neurogenic support. Patients and methods In all, 24 patients (mean age 46 years) underwent a new one-sided anterior dorsal oral mucosal graft urethroplasty while preserving the lateral vascular supply to the urethra, the central tendon of the perineum, the bulbospongiosum muscle and its perineal innervation. The cause of stricture was instrumentation in three cases (12%), unknown in five (21%), infection in four (17%), and lichen sclerosus in 12 (50%). The stricture site was bulbar in 12 cases (50%) and panurethral in 12 (50%). The mean stricture length was 4.2 cm in patients with bulbar strictures and 10 cm in patients with panurethral strictures. Of 24 patients, 20 patients (83%) had received previous treatments. Clinical outcome was considered a failure when any postoperative instrumentation was needed, including dilatation. Results The overall mean (range) follow-up was 22 (12-55) months. Of the 24 patients, 22 (92%) had a successful outcome and two (8%) were failures. One failure was treated using definitive perineal urethrostomy and another failure underwent successful internal urethrotomy. Conclusions The preservation of the one-sided vascular supply to the urethra and its entire muscular and neurogenic support should represent a slight but significant step toward perfecting the surgical technique of urethral reconstruction using a minimally invasive approach.

Original languageEnglish
Pages (from-to)1150-1155
Number of pages6
JournalBJU International
Volume104
Issue number8
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Bulbospongiosum muscle
  • Central tendon of the perineum
  • Perineal nerve
  • Urethral surgery
  • Vascular sparing technique

ASJC Scopus subject areas

  • Urology

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