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 language | English |
|---|---|
| Pages (from-to) | 1150-1155 |
| Number of pages | 6 |
| Journal | BJU International |
| Volume | 104 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Oct 2009 |
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Keywords
- Bulbospongiosum muscle
- Central tendon of the perineum
- Perineal nerve
- Urethral surgery
- Vascular sparing technique
ASJC Scopus subject areas
- Urology
Cite this
One-sided anterior urethroplasty : A new dorsal onlay graft technique. / Kulkarni, Sanjay; Barbagli, Guido; Sansalone, Salvatore; Lazzeri, Massimo.
In: BJU International, Vol. 104, No. 8, 10.2009, p. 1150-1155.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - One-sided anterior urethroplasty
T2 - A new dorsal onlay graft technique
AU - Kulkarni, Sanjay
AU - Barbagli, Guido
AU - Sansalone, Salvatore
AU - Lazzeri, Massimo
PY - 2009/10
Y1 - 2009/10
N2 - 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.
AB - 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.
KW - Bulbospongiosum muscle
KW - Central tendon of the perineum
KW - Perineal nerve
KW - Urethral surgery
KW - Vascular sparing technique
UR - http://www.scopus.com/inward/record.url?scp=70349235810&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349235810&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2009.08590.x
DO - 10.1111/j.1464-410X.2009.08590.x
M3 - Article
C2 - 19388990
AN - SCOPUS:70349235810
VL - 104
SP - 1150
EP - 1155
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - 8
ER -