A novel composite two-stage urethroplasty for complex penile strictures: A multicenter experience
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Barbagli, Guido
Batra, Vikram
Surana, Sandesh
Hamouda, Atef
Sansalone, Salvatore
Costi, Dimitris
Lazzeri, Massimo
Hunter, Craig
Desai, Devang J
Castiglione, Fabio
Kulkarni, Sanjay B
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Abstract
Introduction: Complex penile strictures are usually repaired using a two-stage urethroplasty. Buccal mucosal graft (BMG) placed in the first stage can have a significant contraction rate, which may require a subsequent revision surgery. We describe a composite two-stage penile urethroplasty using BMG for patients of complex penile strictures who have some salvageable urethral plate. Methods: Within a multi-institutional cohort, 82 patients underwent a two-stage urethroplasty for complex stricture of the penile urethra. Of these 42 patients who underwent our composite two-stage penile urethroplasty using BMG implanted at the second-stage were included. Patients with genital lichen sclerosus or incomplete clinical records were excluded from this study. The primary outcome of the study was to evaluate stricture-free success rate. Results: Of total 42, 4 patients were lost to follow-up. 42% of stricture etiology was failed hypospadias repair. Mean stricture length was 4.5 cm (range 3-8 cm). Seventeen (44.7%) patients had undergone the previous urethroplasty. At a median follow-up of 44 months, of 38 patients, 34 (89.5%) were successful, and 4 (10.5%) had a recurrence. No patient required revision surgery before the second-stage and required redo buccal graft harvesting for subsequent urethroplasty. Conclusions: The composite two-stage technique in repairing complex penile urethral strictures is a valid and reproducible surgical treatment for complex penile stricture and it may reduce the rate of contraction of the transplanted BMG.
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Indian Journal of Urology
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33
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2
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© 2017 Indian Journal of Urology | Published by Wolters Kluwer ‑ Medknow. This is an open access article distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as the author is credited and the new creations are licensed under the identical terms.
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Health sciences
Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
FAILED HYPOSPADIAS REPAIR
URETHRAL STRICTURE
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Joshi, PM; Barbagli, G; Batra, V; Surana, S; Hamouda, A; Sansalone, S; Costi, D; Lazzeri, M; Hunter, C; Desai, DJ; Castiglione, F; Kulkarni, SB, A novel composite two-stage urethroplasty for complex penile strictures: A multicenter experience, Indian Journal of Urology, 2017, 33 (2), pp. 155-158