The Therapeutic Effect of Perineal Urethroplasty using a Gracilis Muscle Flap in a Recurrent Complete Posterior Urethral Stricture.
10.4111/kju.2007.48.8.863
- Author:
Jin Ha LEE
1
;
Young Tae LEE
Author Information
1. Department of Urology, Bundang CHA Hospital, Pochon CHA University College of Medicine, Seongnam, Korea. ytleeuro@cha.ac.kr
- Publication Type:Original Article
- Keywords:
Urethral stricture;
Urethroplasty;
Gracilis muscle;
Complications
- MeSH:
Constriction, Pathologic;
Erectile Dysfunction;
Humans;
Incidence;
Male;
Urethra;
Urethral Stricture*
- From:Korean Journal of Urology
2007;48(8):863-869
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the usefulness of a gracilis muscle flap for the reconstruction of a complete posterior urethral stricture, where previous treatment had failed. MATERIALS AND METHODS: Between March 1998 and April 2006, 56 patients, in whom previous urethroplasty or visual internal urethrotomy had failed, were treated with a gracilis muscle flap. All patients had been referred from other institutions. Of the 56 treated patients, 32(group I) underwent perineal urethroplasty, using a stepwise approach of urethral mobilization, including bulbar urethra mobilization, separation of the corporal bodies, inferior pubectomy and retrocrural urethral re-routing 24(group II) underwent perineal urethroplasty, with a gracilis muscle flap for replacement of the dead space, using a stepwise approach. RESULTS: The mean stricture lengths were 2.7(0.5-5.5) and 3.5cm(1.0-6.5) in groups I and II, respectively(p=0.135). The success rates were 87.5 and 95.8% in groups I and II, respectively(p=0.279). The success rates of patients with urethral stricture of greater than 3cm were 71.4 and 100% in groups I and II, respectively(p=0.037). The success rates of patients who had undergone previous perineal urethroplasty were 82.6 and 100% in groups I and II, respectively(p=0.045). A gracilis muscle flap made no difference to the incidences of erectile dysfunction and incontinence. The incidences of restricture were 15.6 and 0% in groups I and II, respectively (p=0.042). CONCLUSIONS: Our results showed that a gracilis muscle flap can be useful method with a stricture greater than 3cm in length and in patients having undergone previous perineal urethroplasty.
