Surgical Outcome of Urethroplasty Using Penile Circular Fasciocutaneous Flap for Anterior Urethral Stricture.
10.5534/wjmh.2014.32.2.87
- Author:
Kyoung Rok KIM
1
;
Jun Gyo SUH
;
Jae Seung PAICK
;
Soo Woong KIM
Author Information
1. Department of Urology, Seoul National University Hospital, Seoul, Korea. swkim@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Penis;
Surgical flaps;
Urethral stricture
- MeSH:
Cystostomy;
Fistula;
Follow-Up Studies;
Humans;
Male;
Penis;
Recurrence;
Retrospective Studies;
Surgical Flaps;
Urethral Stricture*
- From:The World Journal of Men's Health
2014;32(2):87-92
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Penile circular fasciocutaneous flap urethroplasty is a useful technique for a long anterior urethral stricture due to the flap's hairless nature and ample length. We investigated the surgical outcomes of urethroplasty for a complex anterior urethral stricture, performed using a penile circular fasciocutaneous flap. MATERIALS AND METHODS: Between 2008 and 2013, we performed a retrospective review of 29 patients who underwent urethroplasty using a penile circular fasciocutaneous flap and had at least 6 months of follow-up. A total of 20 cases utilized only a fasciocutaneous flap, while 9 cases combined a fasciocutaneous flap with other surgery. Success was defined as no requirement of additional urethral instrumentation. RESULTS: The overall success rate was 68.9% (20 out of 29 cases) at a median follow-up of 19 months. Furthermore, fasciocutaneous flap urethroplasty rendered the actual stricture-free rate of 79.3%. The location of recurrence was mostly at the junction of the flap. Among 9 surgical failures, 5 cases were treated successfully by using an additional surgical procedure. Fistula repair was needed in 1 case 4 months later. Further, periodic urethral dilation was performed in the remaining 3 cases. The failure rate was significantly higher in patients with suprapubic cystostomy than in patients without suprapubic cystostomy. The most common complication was post-micturition dribbling. CONCLUSIONS: Penile circular fasciocutaneous flap urethroplasty is a useful method for the reconstruction of a long anterior urethral stricture. A sufficient healthy margin should be acquired for better surgical results due to the fact that most recurrence occurs at the junction of the flap.
