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[Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap].
Beijing Da Xue Xue Bao Yi Xue Ban 2019; 51(4):641-645BD

Abstract

OBJECTIVE

To evaluate the clinical effect of single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap.

METHODS

We retrospectively reviewed the clinical database of 22 male patients with penile urethral stricture who received single-stage repair using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap from November 2015 to October 2018. All the cases had no complications, such as skin fistula. The causes of stricture included iatrogenic (14/22, 63.6%), inflammation (2/22, 9.1%) and idiopathic (6/22, 27.3%). A ventral urethrotomy was made in the segment of stricture and extended proximally and distally until the normal calibre urethra was encountered. The oral mucosa graft was secured to the corpus spongiosum in dorsal onlay fashion or underlying corpora cavernosum after resection of the severe scarred urethra. Then the prepared Orandi fasciocutaneous penile skin flap was secured to edges of corpus spongiosum or oral mucosa graft. A 16 F or 14 F Foley catheter was left in situ for a minimum of 3 weeks, at which time a urethrogram was performed to look for extravasation, and the urethroscopy was performed if necessary. Success was defined as an open urethra with Qmax≥15 mL/s and no need for further surgical intervention.

RESULTS

all the 22 patients with a mean age of 52.6 (18-73) years underwent the combined tissue-transfer technique. The mean length of the penile urethral stricture was 5.3 (2.5-10.0) cm and the mean preoperative Qmax was 6.7 mL/s. the mean length of oral mucosa grafts and fasciocutaneous skin flaps were 5.5 (3.2-10.5) cm and 6.0 (3.5-11.0) cm, respectively. The mean operation time was 225 (150-420) minutes and the mean evaluated blood loss was 53 (20.0-110.0) mL. The grafts included buccal mucosa (19/22, 86.4%) and lingual mucosa (3/22, 13.6%). The mean postoperative Q max was 21.2 (15-32) mL/s. A case of skin fistula and 2 cases of recurrent stricture were found, so the technique success rate was 81.8% (18/22) at a mean follow-up of 20.5 (5-51) months. The perioperative complications included 2 cases of infection and skin necrosis, which healed well after conservative treatment.

CONCLUSION

Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap appears to be an excellent option to repair penile urethral stricture with unsalvageable urethral plate and the penile skin is available. The present clinical series showed a successful rate of 81.8% (18/22).

Authors+Show Affiliations

Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing 100096, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

31420615

Citation

Wang, J W., et al. "[Single-stage Repair of Penile Urethral Stricture Using Combined Dorsal Onlay Oral Mucosa Grafting With Ventral Onlay Penile Skin Flap]." Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences, vol. 51, no. 4, 2019, pp. 641-645.
Wang JW, Man LB, Huang GL, et al. [Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap]. Beijing Da Xue Xue Bao. 2019;51(4):641-645.
Wang, J. W., Man, L. B., Huang, G. L., He, F., Wang, H., Wang, H. D., ... Liu, Z. H. (2019). [Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap]. Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences, 51(4), pp. 641-645. doi:10.19723/j.issn.1671-167X.2019.04.008.
Wang JW, et al. [Single-stage Repair of Penile Urethral Stricture Using Combined Dorsal Onlay Oral Mucosa Grafting With Ventral Onlay Penile Skin Flap]. Beijing Da Xue Xue Bao. 2019 Aug 18;51(4):641-645. PubMed PMID: 31420615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap]. AU - Wang,J W, AU - Man,L B, AU - Huang,G L, AU - He,F, AU - Wang,H, AU - Wang,H D, AU - Xu,X, AU - Li,W, AU - Zhai,J P, AU - Liu,Z H, PY - 2019/8/18/entrez PY - 2019/8/20/pubmed PY - 2019/8/23/medline SP - 641 EP - 645 JF - Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences JO - Beijing Da Xue Xue Bao VL - 51 IS - 4 N2 - OBJECTIVE: To evaluate the clinical effect of single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap. METHODS: We retrospectively reviewed the clinical database of 22 male patients with penile urethral stricture who received single-stage repair using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap from November 2015 to October 2018. All the cases had no complications, such as skin fistula. The causes of stricture included iatrogenic (14/22, 63.6%), inflammation (2/22, 9.1%) and idiopathic (6/22, 27.3%). A ventral urethrotomy was made in the segment of stricture and extended proximally and distally until the normal calibre urethra was encountered. The oral mucosa graft was secured to the corpus spongiosum in dorsal onlay fashion or underlying corpora cavernosum after resection of the severe scarred urethra. Then the prepared Orandi fasciocutaneous penile skin flap was secured to edges of corpus spongiosum or oral mucosa graft. A 16 F or 14 F Foley catheter was left in situ for a minimum of 3 weeks, at which time a urethrogram was performed to look for extravasation, and the urethroscopy was performed if necessary. Success was defined as an open urethra with Qmax≥15 mL/s and no need for further surgical intervention. RESULTS: all the 22 patients with a mean age of 52.6 (18-73) years underwent the combined tissue-transfer technique. The mean length of the penile urethral stricture was 5.3 (2.5-10.0) cm and the mean preoperative Qmax was 6.7 mL/s. the mean length of oral mucosa grafts and fasciocutaneous skin flaps were 5.5 (3.2-10.5) cm and 6.0 (3.5-11.0) cm, respectively. The mean operation time was 225 (150-420) minutes and the mean evaluated blood loss was 53 (20.0-110.0) mL. The grafts included buccal mucosa (19/22, 86.4%) and lingual mucosa (3/22, 13.6%). The mean postoperative Q max was 21.2 (15-32) mL/s. A case of skin fistula and 2 cases of recurrent stricture were found, so the technique success rate was 81.8% (18/22) at a mean follow-up of 20.5 (5-51) months. The perioperative complications included 2 cases of infection and skin necrosis, which healed well after conservative treatment. CONCLUSION: Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap appears to be an excellent option to repair penile urethral stricture with unsalvageable urethral plate and the penile skin is available. The present clinical series showed a successful rate of 81.8% (18/22). SN - 1671-167X UR - https://www.unboundmedicine.com/medline/citation/31420615/[Single-stage_repair_of_penile_urethral_stricture_using_combined_dorsal_onlay_oral_mucosa_grafting_with_ventral_onlay_penile_skin_flap] L2 - http://xuebao.bjmu.edu.cn/EN/Y2019/V51/I4/641 DB - PRIME DP - Unbound Medicine ER -